HomeMy WebLinkAboutMechanical Permit 13. 0343 4
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R CITY OF PRIOR LAKE CI
Date Rec'
iro r
7 � HEATING /AIR CONDITIONING /FIREPLACE PERMIT 1 4 I /3
AY 4
4,jNNEsoo I. Pink n City File ' 3 , 0T8
3 PERMIT NO 4 /
2.
3. Yellow Applicant J T
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
ru,c1 -\'\c) C,--t. AE n la
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCKS ADDITION /Cj j ei Mai 34 Q-6Q
OWNER
(Name) Den , 2,e,\5 (Phone) Cik.a - d 1 o)Sg9
(Address) kt-p% N�00 , 4 l : t • NE w(1Qkr (Ate, M V SS 372
APPLICANT
(Name) V7 UYYI S\\\'( J l� 1(■ (Phone) CISZ ceq L - OQ(XS
(Address) _ ... • to.. 1 'Yl \ \ ° 0 , 20 6.. A 11 13 _ 3
(Address) (City) (Zip Code)
(Contact Person) a Wlte- (Phone) C1S24 U "000
APPLICANT SIGNATURE V�9 l ` DATE 11 2, / 3
APPLICANT PLEA E COMPLETE BELOW
❑NEW CONSTRUCTION r/ REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL ' & uA • • 00 FUEL 1
FLUE SIZE RETURN OPENINGS S' ' INPUT 1 001000 OUTPUT C O, (MO
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
E3 Gravity ❑ Hot Water into Required Side Yard Setbacks.
7.! Mechanical ❑ Radiation
❑Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
['Vent. System 0 Other Devices Cantilevers to the Outside of Buildings
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
Estimated Cost $ ap,bo-00 Building Permit #
HEATING PERMIT FEE $ (D` \.5
STATE SURCHARGE $ ..60
'I
TOTAL PERMIT FEE $ ( 0 C .
(Office Use Only) ('1 Q..' •iLI5 � ?—
This Application Becom :. Your Building Permit When Approved ' : l 0 Receipt No.&fjb
4 . A i tt 1 B: a Jffi Date to
1 (3
�I 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372