HomeMy WebLinkAboutMechanical Permit 12. 0683 J
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p CITY OF PRIOR LAKE Date Rec'd
1)
HEATING /AIR CONDITIONING /FIREPLACE PERMIT
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41 INNESO 'c� 2. 1. PiYeg File e PERMIT NO. /2____6k3
3. Yellow Applicant
(Please type or print and sign at bottom)
7 01
ZONING (office use)
5 0 (irc(P SE taKe
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER A4 dili14 (f( (Phone 1 ✓ `� 71 5 L
(Address) OP Cle Hr(Or Me
APPLICANT
(Name) Rons mechanical Inc (Phone) 952 - 445 -8585
(Address) 12010 Old Brick Yard Road Shakopee MN 55379
(Address) (City) (Zip Code)
(Contact Person) L i nda (Phone) 9 9 2 4 4 5 8 5 8 5
APPLICANT SIGNATURE yv\Ou...0( DATE 6 80- \ — -
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION VREPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL VZ(,1,1A,D iM L) L0 I 2 - 1 - ( 5 Y 1 FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
['Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
['Gravity ❑ Hot Water into Required Side Yard Setbacks.
• Mechanical 0 Radiation Fireplaces with Box Additions or
t! , it Conditioning ❑ Special Devices
■Vent. System 111 Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
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
The Minnesota Statutes § 326B.148 'ost $ Building Permit #
"SURCHARGE" has been extended
until June 30, 2013, HEATING PERMIT FEE $ 4 i,
The minimum surcharge for a STATE SURCHARGE $ `� .50
"fixed fee" permit is $5.00 TOTAL PERMIT FEE $ 14
This Application Becomes Your Building Permit When Approved Paid J C-) Receipt No. • / 2_ 74,
Buildine Official Date Date / `, I By
J. , r:
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372