HomeMy WebLinkAboutMechanical Permit 13. 0068 ui
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y RIO CITY OF PRIOR LAKE Date Rec'd
,� rw *, e HEATING /AIR CONDITIONING /FIREPLACE PERMIT
tr "
. `tii I. Pink File k3_a
2. Green City PERMIT NO . 6 r
j 3. Yellow Applicant (((VVV
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/ 5:3 D---..-- c pc.16-7-(---- 'Ed
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER (1-� — S 7 O ) s
(Name) `Q (Phone .
(Address) / 5 "--D......- l L A ( (1 f ' ied
APPLICANT •
(Name) _ • • _ • ..' • • • • 1 . (Phone)
an.ar• - • ■
(Address) 130 Plymouth Avenue North r
Mlnneapuli5, MN/55411-3445
612 -824 t
(city) (zip Code)
(Contact Person) An • ilI (Phone) •
� ar ' DATE
APPLICANT SIGNATU • A _
APPLI 4 T PL . SE COMPLETE BELOW
❑NEW CONSTRU ION a; ' .PLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL _4 *4 O'Wy 9 y5 FUEL Wild S
FLUE SIZE RETURN OPE . ■ S INPUT 60 6 j & WUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
Warm Air Plants ❑Steam Units and Fireplaces Cannot Encroach
Gravity ❑ Hot Water
Mechanical El Radiation into Required Side Yard Setbacks.
Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
[Went. System ❑ 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
(
Estimated Cost $ l '-` 3 Building Permit # `� l
The Minnesota Statutes *32613.148
HEATING PERMIT FEE $ y . S a "SURCHARGE." has been changed for one
year effective
STATE SURCHARGE $ .dXy54. July 1, 2010, until June. 30, 2011.
TOTAL PERMIT FEE $ S ( l��O The minimum st for a "fixed fee" permit
(Office Use Only) ( is , beginning July 1.2010
This Application Becomes Your Building Permit When Approved Paid j-4/ gJ Receipt No.
Date , _ 43 By
Building Official Date `/�/
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372