HomeMy WebLinkAboutMechanical Permit 13. 1245 J
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04 PRio� CITY OF PRIOR LAKE Date Recd
( Ah :,'t HEATING/AIR CONDITIONING/FIREPLACE PERMIT
411n'NESO 1 Pink Fde ile _
- 2 Green FPERMIT NO.,3 /�TJ
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
146r0 Bridk r,N.6 ‘,e, Tht i f
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
(Name)
OWNER( V4
[�
(Phone) l Z
(Address) /p O i tM/e, R II I
APPLICANT/7„,, Q ,
(Name) (...al r �' t C1 (Phone) '�Z ,� L_
MIN
(Address) 40.2 lel w ,4 Ave E P t 34
(Add ss) (City) -r��"
(Zip Code)
(Contact Person) 64.or ►. 11 , (Phone) 14r-11:44
APPLICANT SIGNATURE i%; ,, Ih ' /.. DATE r04174a
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL eetirNer *577p ) /71& FUEL No
FLUE SIZE2"fl'G RETURN OPENINGS -- INPUTr OUTPUT 76,e
TYPE OF SYSTEM HEATING OR POWER PLANT
Warm Air Plants PLEASE NOTE: Air Conditioner
❑Steam
il
Gravity ID Hot Water Units and Fireplaces Cannot Encroach iEll
into Required Side Yard Setbacks.
12 Mechanical ❑Radiation
Air Conditioning El Special Devices Fireplaces with Box Additions or
Cantilevers to the Outside of Buildings
OVent.System ID Other Devices
Require a Building Permit.
FIREPLACE MAKE AND MODELj�
FEE SCHEDULE 7, V/
`��
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 $49.50
o
'- Cost$ Building Permit # i
The Minnesota Statutes§326B.148
"SURCHARGE"has been changed for one HEATING PERMIT FEE $ �e awl f/ ,,,,P
year effective STATE SURCHARGE $ *.// > t
July 1,2010,until June 30.2011. TOTAL PERMIT FEE I
The minimum surcharge fora"filed fee"permit
$ % I�
is 55,beginning July 1,2010
This Application Becomes Your Building Permit When Approved Paid , Receipt No.
Date ///443 By , )._,,,,,,,,c,,
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