HomeMy WebLinkAboutMechanical Permit 13.0733, Bldg 13. 0690 O1 pRr04, CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
1.Pink File PERMIT NO.
4/INNESO 2.Green City )3 ._.. 6 r
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
rib o5 X/eczei6
Cr6 3/ 5.1
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
ONE(Nam)R C VIK (/Za0)(A — /V PavvAcc(cos s (Phone) 960H5-4(497,c
(Address) /6276' /ti 9t1&VO �3 4) ,. e_ )2 '0 78
APPLICANT �I
( C0/\ \AiLa ii,. j 60\ (Ph9np) 9sy, -:;-& O kU
(Address) Ls .4 _,,,It0 _ ,L LA 4 /(/f/12"3/Cr
(Contact Person) /e(C i�,/ . C.-C.---ror
(Phone) Q(&7
APPLICANT SIGNATURE i eDATE J 7-313
13
rICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION IMEPLACEMENT ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
❑Warm Air Plants ❑Steam Units and Fireplaces Cannot Encroach
❑Gravity 0 Hot Water into Required Side Yard Setbacks.
❑Mechanical 0 Radiation Fireplaces with Box Additions or
❑Air Conditioning ❑Special Devices f& S I I i1C Cantilevers to the Outside of Buildings
❑Vent. System 0 Other DevicesE' 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 $5.9G
This Application Becomes Your Building Permit When Approved PaidT_4-v Receipt No.
Building Official Date Date 71f//3 13.? ".„.6
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372