HomeMy WebLinkAboutMechanical Permit 13. 0965 ol PR/0 CITY OF PRIOR LAKE U J ) Date Rec'd
. c HEATING/AIR CONDITIONING/FIREPLACE PERMIT 701
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P 1.Pink File
I'\'vEs0� 2.Green City PERMIT NC , �.,
ase type or print and sign at bottom)
3.Yellow Applicant '�
ADDRESS ZONING(office use)
6L 6)^4(11 itiard 6/.
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
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OWNER 0 �'( 3,760
ame (Phone) 6/z- $4', -
(Address) 0 422_. 6;,.-ce• 0-0J �C—
APPLICANT & // /4C
ame ,/ (Phone) CJS/ 2—t/9--9,�Z Z—
(Address)
(Address) Ca / Cc.-
(Contact Person) el 'A. .A (Phone) dZ—ed 9—93 2
APPLICANT SIGNATU DATE 9'"'-C"/-3
• APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION 4LTERATIONS
FURNACE MAKE ND MODEL UEL
FLUE SIZE RETURN OP7REPLACEMENT
S INPUT ,�(�^ OUTPUT "
TYPE OF SYST M
HEATING OR POWER PLANT V,i
PLEASE NOTE:Air Conditioner
O Warm Air Plants 0 Steam Units and Fireplaces Cannot Encroach
O Gravityter into Required Side Yard Setbacks.
❑Mechaical ❑Radia on q
❑Air ConditioningFireplaces with Box Additions or
O Special Devices Cantilevers to the Outside of Buildings
❑Vent. System OOther Devices Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial,Commercial&Multi Family 1%of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential,Heating&A/C(New Construction) $149.50 Residential,Additions&Alterations $49.50
Residential,Heating Only(New Construction) $64.50 Residential,AC Only $49.50
Cost$ Building Permit#
HEATING PERMIT FEE $
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $ 64.50
4pplication Becomes Your Building Permit When Approved Paid J/ SO Receipt No. 9(V
Building Official Date Date �3 By4 I' 7
24 hour notice for all inspections(952)447-98507 °'/,
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372