HomeMy WebLinkAboutMech Permit 01-1154
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS
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3. Yellow Apphcant V tJ <-f
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LEGAL DESCRIPTION (office use only)
IL/qLI5
LOT
BLOCK
ADDITION
OWNER rJ) - ~d
(N ame) Z-v La
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(Phone) 9 G~ -tiLl 7-lifS 7
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(Address)
APPLICANYJ .. -r .D
(N ame) { /,. c:r c.: ~ r-r-
(Phone)
(Address)
(Address)
(City)
ZONING (office use)
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PIDc~5- ~s;p- 0/7- c'
(Zip Code)
(Contact Person) _ / / (Phone) .
APPLICANT SIGNATURE~~~~~~ DATE /O~~ I
. (APPL~~T PLEASE COMPLETE BELOW I /
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
INPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
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Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3q~.5'6
.50
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(Office lJse Only)
This Application Becomes Your Building Permit When Approved
Paid 1fO~oO
Date/
[6-1d--0}
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Rec1J;~OLI
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