HomeMy WebLinkAboutMechanical Permit #12-1260 � ❑❑� c� a�oaoo o� v y�
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� YRZ CITY OF PRTOR LAKE Date Rec'd
° �� ` �`�f�M�' HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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�r iN N E SO ��' I. Pink P��� PERMIT NO. Z—�,�
2. Green City /
3. Ye11ow Applicant
Please e or ' t and si n at bottom
ADDRESS � � r .� r s . \ _' ZONIlVG ���s�� ��,
��� c.� ��,rn pk,,,nS 1J vV
LEG.AL DESCRIPTION (oflfice use only}
LOT BLOCK ADDITION PID
(Na � l � W r�l �'�'� (Phone) � � C71 �CD J OI �/
cA�ss, 3� t��l � 1C�s �' St�v -
APPLIC ,(� � �J� !,1 .� � Z y y L
(Name) 1 LV`M (Phone) -� '�K �
(Address) — I � � ' �
(Address) (City} (Zip Code)
(Contact Person} ��k-JU � O P�✓�^ ne) �'� '-� � � y � � Ll
APPLICANT SIGNATURE DATE /G""r9 /Z.
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION PLACEMENT Q ALTERATIONS
FURNACE MAKB AND MODEL �( )✓� l3� F118L N C�t� G�'�
FLUE SIZE �� RETURN OPEN�TGS INPUT C.,Q C.D d�� OUTPUT � I��
i
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
OWarm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
,eJGravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation
QAir Conditioning ❑ Speaial Devices Fireplaces with Boz Addition�s or
�Vent. System ❑ Other Devices Cantilevers to the Ontside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi 1% of job cost Residentia(, 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
Fstimated Cost $ ��'� � Building Permit #
Tl�e Minnesotl Sk�tutes �. 32G13.148
HEATING PERMIT FBE $ N q. J� "SURCEl�1RGF.;'" hws been ch�znged lor one
year e1'fcctive
STATE SURCHARGE $ .T,�. Ul� .5Q .)u1y �, zt►1t� �zretil.J«nc3t� 2ot.►.
TQTAL PERMTT FEE $ �, � Thc minimn�n sarcharge for a "li�ecl fcc" permit
(Oftice Use Only) is �,,;, beginning.i�fFy l.2UlU
This Application Becomes Your Building Permit When Approved Paid /—i/ �—v Receipt No. � �///
�7 `� �r
Date / /ll� /� By �
Butldine Officiat Date ��
24 hour notice for at1 inspect�ons (952) 447-9850, fax (952) 447-A245
4646 Dakota Street S.E., Prior Lake, Minuesota 55372