HomeMy WebLinkAboutMechanical Permit 14. 0102 J
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iRto CITY OF PRIOR LAKE Date Rec'd
�e HEATING/AIR CONDITIONING/FIREPLACE PERMIT 2 , 2-4_ 14--
t3 ---1/\/// _ 97
soMvEsdc' IP� File PERMIT NO. / • / ) 7
3 Yellow Applicant G
(Please type or mint and sign at bottom)
ADDRESS Z9NING(office use)
k24 mblcwoud Dr . NE
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION pm, 2-3-- 34I O. 000,o
OWNER
(Name) S h e l Li-Z S 1,-1 ow.) Irl GONG-e (Phone)
(Address) S 4 2 k Pt---n4 tJ 1.-e\ J 0 O CI, p r• N
APPLICANT
(Name) L► 1, r 10 \ac-c. (Phone) CirJ Z' c l 4 -C ' )
(Address) (2,5)-1 Ce cA. (Address)UaCi r c l , Eduiv`O , ivtty) N SS 4 Code)(Zip
(Contact Person) M V t 0-C I L ANi-2.1i-'e IVO Y t V 1n. (Phone) 9 r'J' -141-2(R g S
1I
APPLICANT SIGNATURE t d Y DATE Z 'Zd
APPLICANT PLEASECOMPLETE BELOW
0 MEW CONSTRUCTION2 II PLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL 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 0 Hot Water into Required Side Yard Setbacks.
❑Mechanical 0 Radiation Fireplaces with Box Additions or
:kir Conditioning 0 Special Devices
❑Vent.System 0 Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL Lzri SOX Mr DF 40 IN
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 $4930
-•-'Cost$ 7-1000 Building Permit #
The Minnesota Statutes§326B.148
"SURCHARGE"has been changed for one HEATING PERMIT FEE $
year effective STATE SURCHARGE $ .50
July 1,2010,until June 30,2011. TOTAL PERMIT FEE $ 54.CDO
The minimum surcharge for a"fixed fee"permit
is SS,beginning July t,2010
This Application Becomes Your Building Permit When Approved Paid q 5— Rece. No. ..?0..7 e
Date Z / By
Building Official Date
24 hour notice for ail inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372