HomeMy WebLinkAboutMechanical Permit 15. 0367 CD
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(:) ..<143 , .RrCITY OF PRIOR LAKE Date Reed
a ,f417 1M.e
HEATING/• ' : : $NING/FIREPLACE PERMIT
•
•
dflNNEso'CP 5(7,5-0 1. Pink File PERMIT NO.
2.Yellen., nt f n City / ,-7
I 3. YYellen., Applica � �L
(Please type or print and sign at bottom)
ADDRESS ! ZONING(otficc:use)
• S".4i 1 /Vl4o3 ( ri 5-E
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (k4-f7 (
(Phone)a'(4 •S ( ..)--
. -
cep
/ ' �(Address) 1 4f f/ e17 / 5 -
APPLICANT
(Name) • . .• ...1'•l'l• (Phone)
anew, •
•(Address) 130 Plymouth Avenue North
Minneapolis,MN 55411-3445 (City)
612-824( res) (C (Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATU DATE N
APP CA 'T PLA E COMPLETE BELOW
❑NEW CONSTRU N PLACEMENT
El ALTERATIONS
FURNACE MAKE AND MODEL G✓yy �J .. /01. FU r i ' is
INGS l(
FLUE SIZE RETURN OPENINPUT 60 ! 8"11" OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT —
Warm Air Plants PLEASE NOTE: Air Conditioner
❑Steam Units and Fireplaces Cannot Encroach.
Gravity ❑Hot Water
❑Mechanical ❑Radiation into Required Side Yard Setbacks.
. Air Conditioning ❑Special Devices Fireplaces with Box Additions or
Vent.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 $49.50
Estimated Cost$ s''.14.4° Building Permit #
The Minnesota Statutes*32613:148
HEATING PERMIT FEE $ , gt "St.IRCI IARGI:."has been changed for one
Year effective
STATE SURCHARGE $ ..&el. Jaly I,2010,until.lune 30,2011.
TOTAL PERMIT FEE $ 5--,( 50 ,the minimum surcharge for a"fixed fee"permit
(Office Use Only) is,SS,beginning July 1.29111
This Application Becomes Your Building Permit When Approved Paid �� eipt No. I
L CI )
Date I/ ri/-1, .(
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