HomeMy WebLinkAboutMechanical Permit 15. 1021 J
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41!..R4,04, CITY OF PRIOR LAKE Date Rec'd
s, `r. " h e,_ HEATING/AIR CON u c-•' NG/FIREPLACE PERMIT
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41!NNEsoCt* S b 1. pink File•
j 2. Green City PERMIT NO. /� f O /I
.l. Yellow Applicant 1 S' ( 2
(Please type or print and sign at botto
ADDRESS
5•.*'ZTcj
ZONING(oHiceuse)
'^iv l/ l�
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER !/ k_a-ht,ici(Name) a - C�/
(Phone) 6 s/ D'�P 0 ((O 7/
(Address) C --.".C?)----- CGj/yt
(',-cam_ -7-,-'/
APPLICANT
(Name)
Standard Heat'rg&Air Conditioning (Phone)
(Address) 130 Plymouth Avenue North
Minneapolis,MN,554-11-3445
612-8248t5s) As
" (City) (Zip Code)
(Contact Person) .61h Ain (Phone)
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APPLICANT SIGNATURE grir4A - IA E . EHL/
S
APPLICANT 4 A E COMPLETE BELOW
❑NEW CONST CTIONt' REPLACEMENT 0 ALTERATIONSn .
FURNACE MAKE AND MODEL L( rn�� /In 30ciN� FUELyt.e( 5 G6
FLUE SIZE RETURN OPENINGS INPUT (Os,41°0 OUTPUT .
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air Plants PLEASE NOTE: Air Conditioner
St
❑Gravity Hot Water Units and Fireplaces Cannot Encroach
❑Mechanical adiation into Required Side Yard Setbacks.
DAir Conditioning D Special Devices Fireplaces with Box Additions or
[Went.System D 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 $49.50
Estimated Cost$ I ( 9 S Building Permit it
'Hie Minnesota Statutes`s 32613.14$
HEATING PERMIT FEE $ v "SURCHARGE"\RGE"has been changed for one
• year e ve
STATE SURCHARGE $ O .1 Jtiuly i,2010,rrnidfil Junegc 30,2011.
TOTAL PERMIT FEE $ u . The minimum surcharge for a"fixed fee"permit
(Office Use Only) is tis,beginning July 1.211111
This Application Becomes Your Building Permit When Approved PaidReit No.
Date �? t is"Official Date J
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372