HomeMy WebLinkAboutMechanical 06-1080
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
12--. (, ,vi...>
(Please type or print and sign at bottom)
ADDRESS
1. Pink File PERMIT NO
2. Green City . /- . /080
3. Yellow Applicant if
/'1'/)3 WIfII/Stb iv-I ~ &
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
13/1} -It / /dJ!i:iJn
,s;~ ~h
ZONING (office use)
PID
(Phone) 15).. lf17..-)JJ /
(Jj, u
/(lffv/b;; f b~/IJ V1
/3/1h;) tJ.d~JV&fJJc
(Address)
(Contact Person) ! ~d f!})- 2{)/ -5010
APPLICANT SIGNATURE .~;;;;; _-~~
-" . ~
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ':x:J REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
hi/} 55t3tJ1
(Zip Code)
7;3 --757 wl/J(]J
JJ--d-g<~
(Address)
APPLICANT
(Name)
(Phone)
(Address)
/fMlA
, , (City)
(Phone)
DATE
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
REA TING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
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Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
c3f. ~(/
.50
7a~t'/
'lice Use Only)
fhis Application Becomes Your Building Permit When Approved
Paid !d, /IlJ
Date I 2. 1. tJ~-
Building Official
Date
~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
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Rec~!f No. 52 t. c.; J
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