HomeMy WebLinkAboutMechanical Permit 14. 0779 J
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CITY OF PRIOR LAKE Date Rec'd
° 9t., HEATING/AIR CONDITIONING/FIREPLACE PERMIT g S-, /�644:
M
1.I'i, File PERMIT NO. f -7 7
+kNESOK� 2.Green City 6
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
/AUSS RAS S .C C Y' ( lAati-
LEGAL
DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNERI' Q
(Name) C J (Phone) -151, -- 1g _42,.
(Address)14 l4S'S Q V(1516,,ArkitJt- (C. • Q Yt ilf -CA-6 J
APPLICANT t a
(Name)________W ( cJ
4e-Ck (1
LLQ y (Phone) G\2 e 5 ' _ J
c U Q�
(Contact Person) C 5 5 (Phone)
'l DATE 1
APPLICANT SIGNATURE .1,2 _,. nil)Li_
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION P ' PLACEMENT DALTERATIONS
FURNACE MAKE AND MODEL CUA y 5 G S-4 FUEL
FLUE SIZE RETURN OPENINGS INPUT °G OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
0 Warm Air Plants QSteam Units and Fireplaces Cannot Encroach
0 Gravity DHot Water into Required Side Yard Setbacks.
0 Mechanical 0 Radiation Fireplaces with Box Additions or
DAir Conditioning ❑Special Devices Cantilevers to the Outside of Buildings
DVent. System DOther 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 -g950
Residential,Heating Only(New Construction) (7�$64.50 Residential,AC Only $49.50
Cost$ 7-`•Sb Building Permit#
HEATING PERMIT FEE $
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When Approved Paid SU Receipt . 7(y/
f
Building Official Date Date -'sit By -
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372