HomeMy WebLinkAboutMechanical Permit 11. 0772 J
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4 p Rl CITY OF PRIOR LAKE Date Rec'd
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HEATING /AIR CONDITIONING /FIREPLACE PERMIT
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I NNES0 ; 1. PYeink Fi C i t y / J l e PERMIT NO. ••• ---��7
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3. Yellow Applicant / `
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
4 E.3(o B LL--i eckef - ` —
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
a rrirrc_v (Phone) - QC M\ —cD 3 3
(Address) _>t «_e. _ c T ((C LtQ. r1J 55 . )-1 -
APPLI T t �, ►� -� (`(`�
(Name) ,I )Lr �n `, `� � (Phone) �') �7r�C ) \' -1 �"�'''I
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(Address) Jl� 14 i r-- t s )
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(Address) (City) (Zip Code)
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(Contact Person) LY LI t (Phone) G 6 1 1 C- C 1
APPLICANT SIGNATU c, d, 4 .j-L____ DATE g 1 H 1
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION [ f REPLACEMENT ❑ ALTERATION
FURNACE MAKE AND MODELP U t C -
LJ R in--A FUEL , ra (
FLUE SIZE (0 RETURN OPENINGS INPUT LC (it" OUTPUT 1 ( - `r5 - ')
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
EGravit ❑ Hot Water into Required Side Yard Setbacks.
Ii , echanical ❑ Radiation
r it Conditioning ❑ Special Devices Fireplaces with Box Additions or
■Veent System ❑ Other Devices
Cantilevers to the Outside of Buildings
Require a Building Permit.
AKE AND MODEL l ( -Ca4 1 -ik
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
'LW 1V111111GJULa JLaLuLGJ N J .0 ).1YU )St $ - 1 Building Permit #
"SURCHARGE" has been changed for one ,
year effective �
July 1, 2010, until June 30, 2011. [EATING PERMIT FEE $ T
The minimum surcharge for a "fixed fee" permit TATE SURCHARGE $
is $5, beginning July 1, 2010 OTAL PERMIT FEE $ PMZ 3 ,- -,e', -
This Application Becomes Your Building Permit When Approved Paid ; z) Rece' /No. / 3 r 5
Buildine Official Date Date O/' / ry / / .!
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24 hour notice for all inspections (952) 447 -9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372