HomeMy WebLinkAboutMechanical Permit 16. 0300 E O -Ye
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ov PR/0+ CITY OF PRIOR LAKE Date Recd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT 9 /2. /6
nr1NNEso'�r 1.Pink File PERMIT NO. /lQ
2.Green City I / _ 360 fie,
(Please type or print and sign at bottom) 3.Yellow Applicant ` �/ I
ADDRESS
l 6 el s w e5 t� r Y k 11 c. S w, ?i'ldrt,Ice 7 ZONING(office use)
, M� SS3 d
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) kir IC ti-Pte 55
(Phone) CIS()- a 6 )- 7 60
(Address) me I S we/ f fury Avt Sw.
APPLICANT ,
(Name) I.;,0 w t rvt<,4.,.....k. ..S.„) 0 I O A5 c a c) GLI'c2 c(s,
(Phone) -
(Address) Y/5 ( Do 4204-6` 5 i'• E. Fal`.=1,�14 ti of
(Contact Person) cr.co .c Q p 03 c.. (Phone) <o I a- CI..Cog- GC'i/
APPLICANT SIGNATURE1— k.,(\04 _ . DATE c. H'-tol --i ,
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION NIREPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL j r A...,_ �'6w'L. FUEL /J44`-3e-I 5'S
FLUE SIZE Li" RETURN OPENINGS INPUT /cb o by OUTPUT `10l o 00
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air PlantsPLEASE NOTE:Air Conditioner
0 Steam Units and Fireplaces Cannot Encroach
Gravity
0� lechanical 0Hot Water into Required Side Yard Setbacks.
❑Radiation Fireplaces with Box Additions or
El Air Conditioning ❑Special Devices
Cantilevers to the Outside of Buildings
0 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
Residential,Heating&A/C $49.50 minimum
(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 $ yam(/
STATE SURCHARGE $ .
TOTAL PERMIT FEE $ rS)..-KZ
This Application Becomes Your Building Permit When Approved Paid
Receipt No...iird
Building Official Date Datg�_1Z./� By#2/1„
24 hour notice for all inspections(952)447-9850 L
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372