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HomeMy WebLinkAboutMechanical Permit for 10.0150 �� PR 10� CITY OF PRIOR LAKE Date Rec'd HEATING/AIR CONDITIONING/FIREPLACE PERMIT filo'E SOS 2 I. Pinkreen Piilery PERMIT NO. G 0 150 3.Yellow Applicant 5 O • (Please type or print and sign at bottom) ADDRESS JV � ZONING(office ILlVf�'y 0 il�vl 5 7 "'wi d r use) LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER �/ (Name) KC-17)-1 70L'J (Phone) ' (Address) A(IPPLtI jANT F`fl► ✓ 1 IJ S 1 .(M1,-1� : )4001 L (Phone) (05-1- 03- 10'1 2_ (Address) f o FAL i 11--1 i L F\1 /J ' SE V l U,.- Iki ' 1 /3 (Address) (City) .. (Zip Code) (oE Z. (Contact Person) ;' 4 (Phone) I- (033—10L! APPLICANT SIGNATURE 411r.itir '� '' DATE _____34_1_k APPLICAN WLEASE COMPLETE BELOW ONEW CONSTRUCTION ❑REPLACEMENT El ALTERATIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT ['Warm Air Plants ❑Steam PLEASE NOTE: ['Gravity ❑Hot Water Air Conditioner Units ❑Mechanical ❑Radiation Cannot Encroach into ❑Air Conditioning 0 Special Devices Required Side Yard ❑Vent.System ❑Other Devices Setbacks FIREPLACE MAKE AND MODEL IVI /7 e 5 CAPL-: 3 b1AJ FEE SCHEDULE co Industrial,Commercial&Multi-Family 1%of job cost Residential,Gas Fireplace g ` 41 $39.50 minimum Residential,Heating&A/C(New Construction) $99.50 Residential,Additions&Alterations $39.50 Residential,Heating Only(New Construction) $64.50 Residential,AC Only $39.50 Estimated Cost$ Building Permit # HEATING PERMIT FEE $ STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ (Office Use Only) This Application Becomes Your Building Permit When Approved Paid5Q QQ Receipt No—9b?7 Date j5 ,( 0 B, 7 Building Official Date G 24 hour notice for all inspections(952)447-9850,fax(952)447-4245