HomeMy WebLinkAboutMechanical Permit 11. 0651 LC� U ,sc� Liii7 Cl� vd;l c..... /
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Date Rec'd
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Sw BEATING/AIR CONDITIONING/FIREPLACE PERMIT
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414vNEso'�t. Z: PERMIT NO.
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653
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Mane title arPelt sad sla arbotlom) .
ATRI ZONING office use)
1 34957 w U-oel 11.4.t)G i r. i
LEGAL DESCRIPTION(office use only) .
L HiiDCK M)DTTl10N PIS il
1 OWNER �cn C Mi.1l ns (Phone)
I (Address) 3,257 WcrocA 01,4. Dr.
APPLICANT
Hearth&Home Technologies,lnone)
(Name) dba Fireaido Hoarth & Home
License 20512060
(Address) 2700 N. Fairview Ave.
(Address) - HosevDle, MN 55113 (City) (Zip Code)
651/633-2561
(Contact Person) f�' (Phone)
APPLICANT SIGNATURE /r^���pC/ �� DATE 7/F 81 1
APPLICANT PLEASE COMPLETE BELOW
KNEW CONSTRUCTION 11:1 REPLACEMENT E]ALTERATIONS
FURNACE MAKE AND MODEL kimmiliniAssuilrirC. 04111111111.1011101101C FUEL N t.
FLUE SIZE a - RETURN OPENINGS INPUT OUTPUT
5 Iv
301 eta"
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants 0 Steam Units and Fireplaces Cannot Encroach
❑Gravity 0 Hot Water into Required Side Yard Setbacks.
MMechanical 0 Radiation Fireplaces with Box Additions or
Air Conditioning ❑Special Devices
[Went.System 0 Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL J. w\a c o r C.() 'l?3(4 Z E -e
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 $49.50
Estimated Cost$ Pin•14:-') Building Permit #
The Minnesota Statutes§32613.148
HEATING PERMIT FEE $ 49•S
.�0 "SURCHARGE"has been changed for one
year effective
STATE SURCHARGE $ S vro -`.�'8% July 1.2010.until June 30.2011.
TOTAL PERMIT FEE $ SV Sa The minimum surcharge for a"filed fee"permit
(Office Use Only) is S. beginning July 1.2010
This Application Becomes Your Building Permit When Approved Paid 5R . pt No./_34,'Z
Date
01-t-2-.31 B l0
Baildine Official Date -7, /0 v ) `
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372