HomeMy WebLinkAboutMechanical Permit 16. 0081 ( o O
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UCITY OF PRIOR LAKE Date Rec'do
�° HEATING/AIR CONDITIONING/FIREPLACE PERMIT / 2-976
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1.Pink File Q 6
PERMIT NO. / 3 y 8
/ 1
'/rNxEso'�P 2.Green City
3.Yellow Applicant
(Please type or print and sign at bottom) ZONING(office use)
*ADDRESS
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'[(;.[Z Tr-Zh1( a ri --
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
AINIT"
T'e-4.- _f.S. Y\ (Phone) C3cZ-14�� _-t64i
(Name) b Y1'1zS
(Address) /6 i:)/7 �rez h kfi'Y'
''-" _.52
(Contact Person) (Phone)
APPLICANT SIGN DATE j —2-9 "' / b
APPLICANT PLEASE COMPLETE BELOW
---------11 t CONSTRUCTION ,!2j/ PLACEMENT ❑ALTERATIONS
� FURNACE AND MODEL FUEL
� : RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
0 Warm Air Plants 0 Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑Hot Water into Required Side Yard Setbacks.
❑Mechanical 0 Radiation Fireplaces with Box Additions or
❑Air Conditioning 0 Special Devices Cantilevers to the Outside of Buildings
❑Vent. System 0 Other 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 $ 3.00
TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When Approved Paid 57 - 5-0 Receipt No.4-056
5
Date/ i9 !6 By
Building Official Date --
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372