HomeMy WebLinkAboutMechanical Permit 11. 1147 _�
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rRl CITY OF PRIOR LAKE Date Rec'd
�°� �� 4.
HEATING /AIR CONDITIONING /FIREPLACE PERMIT U
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NN Es( 1 ' ' Pi File I / / / /�
PERMIT NO A
Y
3. YelIloIo City w Applicant / ! I / ( T
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(N R , AL r c. G c (x e- ( Pr k-417 (Phone) q ..2 - P '7S - 70 Fr,
(Address) % -/ / i/ cam' 1 o-r e LG A/c_ 1 r O r L //1 /} s-S 3 7
APPLICANT �
(Name)
/, / (° hone) 03 �� C / 2<s)
(Address) L ' �_" —i.�. 1 =�. 1 •• 1 7 0 P u
(Address) ,/ (City) ( A A � (Zigo�e) '
(Contact Person) , 4 `' cf 4 7 `_t Q (Phone) 7LD3. 4 7 4 ( 7 G, . / ? 9
APPLICANT SIGNATURE _ _.411,1 _ , DATE
APPLICAN� EASE COMPLETE BELOW
ENEW CONSTRUCTION NT REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL / � GI e e yy.. 4 f f/I -0 6. 0 FUEL 1 ' » ' i Q
FLUE SIZE RETURN OPENINGS / INPUT 6CR a OUTPUT
T TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
['Warm Air Plants El Steam Units and Fireplaces Cannot Encroach
['Gravity ❑ Hot Water into Required Side Yard Setbacks.
111 Mechanical ❑ Radiation
['Air Conditioning El Special Devices Fireplaces with Box Additions or
❑Vent. System ❑Other Devices Cantilevers to the Outside of Buildings
tg "r0 ✓c -4 ft- \ 11--- 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, AdditionsISLQjterations $4' 1
Residential, Heating Only (New Construction) $64.50 • esidential, AC Only $49.50
Cost $ d i c S o Building Permit #
The Minnesota Statutes § 326B.148
"SURCHARGE" has been extended HEATING PERMIT FEE $ q9-5 0
until June 30, 2013, STATE SURCHARGE $ '> ∎ 0 °.59-- ((.���,, �'f
The minimum surcharge for a TOTAL PERMIT FEE $ !J t , `D
"fixed fee" permit is $5.00
This Application Becomes Your Building Permit When Approved Paid 3 ` S —3 /. Rec ' t No. 1 (6 p
Date ` B �
Buildine Official Date i I i / '
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372