HomeMy WebLinkAboutMechanical Permit 11. 1304 (Fire Protection Plan) .
1 r CITY OF PRIOR LAKE
U _ Date Rec'd
t, _� z.°' "` 4 n 3; HEATING /AIR CONDITIONING/FIREPLACE PERMIT
Imo I�
= = = 11 t� t \
41 :'^'NEs °o I. Pink Re PERMIT NO. n
(Please 3. Yellow Appfiwat 13 tJ I
(P type or print and sign at bottom)
ADDRESS
44S-140 ZONING (ot6ce use)
, ... , ae&-z)/7-1/ 1
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PJD
OWNER ���, �_
(Name) V t` c ON LC'Q t :, e S ` U t �R c , k --- (Phone)
(Address)
APPLICANT 1 5;2 (Name) " .L '- \ CO. \ (Phone) (C ' S ° 3 CC - 6.(4,
(Address) it 9 a(-) 0V I c' 0,-V., c O L
(Address) (City) (Zip Code)
(Contact Person) --..\OVii\ As (Phone) 1t0 -. 3S &2 ( L
APPLICANT SIGNATURE _ - � _;� r-- DATE 1 I' (S
APPLICANT PLE • E COMPLETE BELOW
ONEW CONSTRUCTION 0 REPLACEMENT ALTERATIONS
FURNACE MAKE AND MODEL .---k 1\S\ - ;5dK \ke (10,1),-5,..---; FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants 0 Steam PLEASE NOTE: Air Conditioner
[]Gravity 0
0 Hot Water Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
❑ Mechanical
❑ Radiation 4
DAir Conditioning 0 Special Devices Fireplaces with Box Additions or
DVent. System 0 Other Devices Cantilevers to the Outside of Buildings
FIREPLACE MAKE AND MODEL Require a Building Permit.
Industrial, Commercial &Multi- Falnil Y 1% of job FEE SCHEDULE
cost Residential, Gas Fireplace $49.50
;$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 $49.50
Residential, AC Only $49.50
Estimated Cost $ \' ( \ Building Permit #
''tt The Minnesota Statutes § 326B.148
HEATING PERMIT FEE $ �f Ly -I :u "SURCIiARGE" has been changed for one
yer STATE S U R C H A R G E $ . 5 . July 1.2010. unti June 3t), 2011.
TOTAL PERMIT FEE $ 5-4 , s--0 The minimum surcharge for a "used fee'' permit
( Office Use Only) is ,S�,, beginning July 1.2010
I(
Mist • , on Becomes Your Building Permit n Approved Paid ReceiptNo.
Ra0d1ag 1 Date „ 'J 1 ^'. ' 1 By y
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 t ✓✓/
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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