HomeMy WebLinkAboutMechanical Permit 15. 0199 .4
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ai rx o, CITY OF PRIOR LAKE Date Rec'd
M t HEATING/AIR CONDITIONING/FIREPLACE PERMIT
ti .A-A
1.Pink File
4tf PERMIT NO9
NNEso�* . `�2.Green City ! - /9
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
/',5 XX, b•-)ib 1,)3 444 Aii 1.--)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER c.
(Name) t r I I J( / (Phone) q J ? I (oe 6
(Address) l 13L%0 t It.)5 e'44''`1 '(i
i
APPLICANTFIRESIDE HEARTH & HOME (Phone)
651-633-1042
(Address) 2700 FAIRVIEW AVENUE NORTH, ROSEVILLE, MN 55113
(Contact Person) Mallory Miller (Phone)
APPLICANT SIGNATURE94-y1MDATE
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ['REPLACEMENT ['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 0 Steam Units and Fireplaces Cannot Encroach
0 Gravity ❑Hot Water into Required Side Yard Setbacks.
0 Mechanical 0 Radiation Fireplaces with Box Additions or
❑Air Conditioning ❑Spec ial Devices Cantilevers to the Outside of Buildings
❑Vent. System ❑Other Devices Require a Building Permit.
FIREPLACE MAKE AND MODEL 'Prj-AJ G ciO Si -75%NI. ,pi.it
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 $ 49.50
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $ 54.50 �j
This Application Becomes Your Building Permit When Approved Paid 5-4 g_ lLeipt No.. C I
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Building Official Date Date 1 , (I t '
24 hour notice for all inspections(952)447-9850 v
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372