HomeMy WebLinkAboutMechanical Permit #13-029 � ❑ 0� C� 00000❑ _ � o Nc?
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o � rRj CITY OF PRIOR LAKE Date Rec'd
� � HEATING/AIR CONDITIONING/FIREPLACE PERMIT
� �
�I�'NES��P `. P"''` F11 PERMIT NO.
2. Green City /� _ a 7�
3. Yellow Appiicant L�
ease e or ' t and si at bottom
ADDRESS
'�"" � ZOI�TING (office use)
�7��� u�h ,���v� o
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER . �
(Name) C / (Phone)q:���C2_-'�! �
(Address) � J QW � A a
�,«_�
APPLICANT /� � '
(Name) G (Phone) � r —
(Address) �/ '� /�'�--
O
(A ess (C' (Zip Code)
� i
(Contact Person) (Phone) S
APPLICANT SIGNAT DATE
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT ��D OUTPi�`
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air Plants PLEASE NOTE: Air Conditioner
❑ Steam
❑Gravity ❑ Hot Water Units and Fireplaces Cannot Encroach
Mechanical ❑ Radiation into Required Side Yard Setbacks.
A�ir Conditioning ❑ 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
��U�'I�I v/ . ����(p��o FEE SCHEDULE
ndustrial, 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
The Minnesota Statutes § 326B.148 ;ost $ Building Permit #
"SURCHARGE" has been extended
until june 30, 2013, HEATING PERMIT FEE $ , v
The minimum surcharge for a STATE SURCHARGE $
"fixed fee" permit is $5.00
I'OTAL PERMIT FEE $ ,
(Oftice Use Only)
This Application Becomes Your Building Permit When Approved Paid Receipt No. 7 �
`�� .5� ro
Date
Buildin¢ Ofticial Date �l� BY �
24 hour notice for all inspections (952) 447-9850, faz (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372