HomeMy WebLinkAboutMechanical Permit 16. 0291 E O
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A. rCITY OF PRIOR LAKE
Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
*NES°
1. Pink File
2. Green City PERMIT NO. ! 24/
(Please ty e or rint and si at bottom) 3. Yellow Applicant
ADDRESS
c "76 1 ' -7-A..., ZONING(office use)
4
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name) i St -c-
Sr. -
(Address) _j//(t�0 (Phone)� — —�
'
APPLICAN ,
(Name) L•Gk
Ic i.. s ,. ,/`
A / (Phone) — L'1 :2 �- c'j'—,//
(Address) ' I(J A,' _40A
,
(Address) dL=i1• 3d
(Contact Person) Ci________t____k_44.9
(City) (Zip Code)
(Phone) _
APPLICANT SIGNATUREL. —/
�=`� DATE '
•P ' ti T PLEASE COMPLETE
NEW CONSTRUCTION ►_; •
BELOW
PLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL
°� ;k(J 5 �l 3 e+"74 FUEL
FLUE SIZE ��7/____4______:"
RETURN OPENINGS INPUT
TYPE OF SYSTEM OUTPUT
HEATING OR POWER PLANT
❑Warm Air Plants 0 Steam PLEASE NOTE: Air Conditioner
!❑GravityUnits and Fireplaces Cannot Encroach
► echanical ❑Hot Water
it Conditioning
❑Special Devices
❑Radiation into Required Side Yard Setbacks.
■Vent. System Fireplaces with Box Additions or
0 Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
Industrial,Commercial&Multi-Familo FEE SCHEDULE
y 1/o of job cost Residential,Gas Fireplace
Residential,Heating&A/C(New Construction)
$49.50 minimum $49.50
Residential,Heating Only(New Construction) $64.50 Residential,A0 &Alterations
Residential,ACCditions Only $49.50
6")
$49.50
Estimated Cost$ 4 Building Permit #
HEATING PERMIT FEE $ 414-S'7-
STATE
ZSTATE SURCHARGE $_____,,_1.00
(Office Use Only) TOTAL PERMIT FEE $ c. ,
5-0
This Application Becomes Your Building Permit When Approved Paid `5Q
C// Receipt No. /ua
Date `7
Building Official i m
--------Tote----- 4-, /(- / By l;p
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372