HomeMy WebLinkAboutMechanical Permit 10.0432 Rr CITY OF PRIOR LAKE 0/1.00n Date Rec'd
C OTS
HEATING/AIR CONDITIONING/FIREPLACE PE ' l�
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� � Floo�� 1.p F,ePERMIT O./0 ¢32,VES 2.Green City
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESSZONING(office use)
C� CA4 & Lv� \ r L
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNE1
(Name) , d. O- ) t E 11 `ir<\ (Phone) •
1-0\ 14 u 1.3
(Address) �'1 v (s—k Cl S cv W \ l 1 1. e e 1`k) - CkA___. k \1 V ç& 31 a
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APPLICANT NyLks--(Name) `l \-,,‘ n n � (Phone) 1 S I- v 1
(Address) 1V° ZS 0 q V) 1 \'V"�,,, QY� V�ci' s c ci I
f. (Address) ( i_ty) (ZipCode)
(Contact Person) N "\� S 0,\ Q .1(,kk (Phone) s 1"1—K vl"`l
DATE 4 s 1 9— 10
APPLICANT SIGNATURE ` _ .
APPLICANT PLESE COMPLETE BELOW
ONEW ( )l CONSTRUCTION�'� pREPLACEMEN�T7 El ALTERATIONS
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FURNACE MAKE AND MODEL�J rk 3S (i,`1 V ‘ 1/41io O FUEL
FLUE SIZE ( V (. v- RETURN OPENINGS INPUT O Q' ) OUTPUT .' • •ilo
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
12Warm Air Plants 0 Steam Units and Fireplaces Cannot Encroach
❑Gravity 0 Hot Water into Required Side Yard Setbacks.
❑Mechanical 0 Radiation
,r Conditioning 0 Special Devices Fireplaces with Box Additions or
Vent.System ❑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 $49.50
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Estimated Cost$ / v% " Building Permit #
HEATING PERMIT FEE $ 1 S 0
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ C Q (/ •
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid VD Recut lyb.03 b I
Dates. tz) B/ .
Buildine Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372