HomeMy WebLinkAboutMechanical Permit #13-067 y �� n ❑O00❑❑ _ � � _�
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� PRtp CITY OF PRIOR LAKE Date Rec'd
, ° � �"��� HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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' � i. r��x File PERMIT NO. /�_� ,
i� � 2. Green City
� � 3. Yelloa� Applicant \
Please e or rint and si n at bottom
ADDRESS ZONING (uH'icc use)
� � C .�z- � 1�A �� ��'
LEGAL DESCRIPTION (office use only)
I.,OT BLOCK .A.DDTTION PID
OWNER
(Name) �� '�° ' (Phon�
(Address} �
APPLICANT
(Name) . . . . {Phone)
an ar
(Address) 130 Plymouth Avenue North
mn ' , -
612 � �� (Ciry1 (Zip Code)
(Contact Person) (Phone) .
APPLICANT SIGNATURE DATE I 1
APPLIC LEASE COMPLETE B.ELOW
❑NEW CONSTR CTION ��EPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AIVD MODEL � f(�i�. ��� V FUEL �s�.
FLUE S[ZE RETURN OPENINGS INpVT ��� � ��
�UT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
.�Warm Air Plants ❑ Steam Units and Fire laces Cannot Encroach
„j� ❑Graviry p Hot Water in to Re uire d Si de Yar d Setbacks.
Mechanical ❑ Radiation q
❑Air Conditioning ❑ Speciai bev;ces Fireplaees with Box Additions or
❑Vent. System ❑ Other Devices Cantilevers to the Oatside of Buildings
Require a Building Permit.
PIREPLACE MAKE AND MODEL
FEE SCIiEDULE
Industrial, Commercial & Multi-Family 1% of job cost Residential, Gas Firepiace $49.50
$49.SQ minimum
Residential, Heating & A/C (New Construction} $149.SQ Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Fstimated Cost $ ��� Building Permit #
'1'Ite Minncsota St�tutes ,��' 32G13.148
HEATING PERMiT FEE $ � SC� "S��RC:I iARGI":" h�s been chtzneed li+r one
year ef('active
STATE SURCHARGE $ . -� .������ i, 2t��o.,��,n:.�t�nc 3�i, zt►� i.
TOTAI, PERMIT FEE $ �I'6c minimum surchar�;e fm•» " ��cd fcr" permit
(Oftice C7se Only) . is f;, be};innin{;.fuly 1.2D10
This Application Becomes Your Building Permit When Approved Paid �� � Receipt Na �
Date `/. ., /� By r .
Buildine OfPcial Date ��
24 hour notice for alI inspections (95Z) 447-4850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 5537Z �