HomeMy WebLinkAboutMechanical Permit 13. 0988 0
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i'Rlo CITY OF PRIOR LAKE Date Rec'd
° HEATING/AIR CONDITIONING/FIREPLACE PERMIT ,�? ,y 73
Z.
41jn'lVESO z.1. k Fiti
o,eePinn eitpe PERMIT NO. �� _619
3.Yellow Applicant _
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
• I Sin ,Fa i r w ON 1-teigirit M NW
R /
LEGAL DESCRIPTION(office use only)
LOT?" BLOCK Z ADDITION ai /2%4-,Cit) / ,4M..v1 PID 2 - .37G- 2s-j
(Name) CIWKruleger (Phone) a s7i 22 (en, • .
(Address) 162645 Fc-,7 I r voy Pk i9 his NW
(Name)APPLIC1` 1 tfi iY i T1C(� I1 Yl Y . VVI(,-Q (Phone) 122 C>)(Si •
(Address) 606 VC,V11 It 6.01 01 a vauui0 N V z -
•
(Ad ress) (City) (Zip Code)
(Contact Person) 1 A 4 (Phone) 2c6c7 (D-2- 2- _
ter, /,./APPLICANT SIGNATURE ,.l J
DATE
APPLICANT PLEASE COMPLETE BELOW
ON EW CONSTRUCTION ❑REPLACEMENT ❑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
DAivity 0 Hot Water into Required Side Yard Setbacks.
❑ echanical 0 Radiation
r Conditioning 0 Special Devices Fireplaces with Box Additions or
❑Vent.System 0 Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE ,
Industrial,Commercial&Multi-Family I%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 $49.50
Estimated Cost$ Building Permit #
The Minnesota Statutes*32613.148 .
HEATING PERMIT FEB $ Hi "SL RC.I IARGye has been ehangel for one
near effective
STATE SURCHARGE $ 6,OtO July 1,2010,until June 30,2011.
TOTAL PERMIT FEE $ 644, O The minimum surcharge for a Nixed I'ee"permit
(Office Use Only) is SC,beginning July 1.2010
This Application Becomes Your Building Permit When Approved Paid s- Receipt No. /dr/-a
Date //�� BA /.
Baildine Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 /
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372