HomeMy WebLinkAboutMechanical Permit 15. 0373 E 00
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oRio+ CITY OF PRIOR LAKE Date Rec'd
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x HEATING/AIR CONDITIONING/FIREPLACE PERMIT '
037-3
cif �P 1.Pink File PERMIT NO
NNEso 2.Green City
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3.Yellow Applicant
/
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
/ 71 03 phe$shcvl - Mead° tv
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
ON(Nam)R t; 4'7- ( 1 o 1 (Phone)'Pn. 2
(Address) /710 3 Ph t a e)1- f vir,hc,a,
APPLICANT f
(Name) A Q t j°1 tei rr i5 (Phone) 6 4?-3( 4-3i/(3#
(Address) r Gtr
(Contact Person) &ad A viv) (Phone) i f' '3 - 3 3/
f ,j
APPLICANT SIGNATURE Alio ;��' �'� ��`wv ilJ DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ,PREPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL , , •r FUEL/1 jaT
FLUE SIZE RETU' OPENINGS INPUT 0 OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
❑Warm Air Plants ❑Steam Units and Fireplaces Cannot Encroach
❑Gravity 0 Hot Water into Required Side Yard Setbacks.
g Mechanical 0 Radiation Fireplaces with Box Additions air
glAir Conditioning 0 Special Devices Cantilevers to the Outside of Buildings
❑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
$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 $49.50
Cost$ Building Permit#
HEATING PERMIT FEE $
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When Approved Paid tz Receipt No./
Date i/ By /I u
Building Official Date �`� �� �'U�-�
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372