HomeMy WebLinkAboutMechanical Permit 11. 1198 j_
p RI0 CITY OF PRIOR LAKEct:9DateRec'd�e HEATING/AIR CONDITIONING/FIREERMIT
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2.Green City /1/ //781PERMIT NO. r3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
Nog g rdalgiciqeTrail
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION ‘/..° PID
(NaWNER a hfrnes (Phone) 218 9-1743'.
(Address) igsgffi 1 Rid? ire
AP(Name)ANViCOffnor Gine &Lir /-(�I ../��7 V 77
(Phone) (Q1/r 7"cJ/ -Y� ! /
(Address) ivy uer/lll i Un = th2WuiaL `1tiYl ff
(Address) (City � (Zip Code)
J2Jnie(Contact Person) a (Phone) 1&f/—(T3` Li/77
APPLICANT SIGNATURE dri/AI A/ %/- /' • DATE ____LD/24 2-D/I
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APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION
// ?REPLACEMENTn /� ❑ALTERATIONS
FURNACE MAKE AND MODEL Ca J win ` I,VCV70 FUEL
FLUE SIZE RETURN OPENINGS INPUT 7D/� OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT j
['Warm Air PlantsPLEASE NOTE: Air Conditioner
0 Steam Units and Fireplaces Cannot Encroach
echanical ❑Hot Water into Required Side Yard Setbacks.
?ravity
❑Radiation
ir Conditioning ❑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 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 $49.50
r'-'—`-a Cost$ Building Permit #
The Minnesota Statutes§326B.148
"SURCHARGE"has been changed for one HEATING PERMIT FEE $ % '50
year effective STATE SURCHARGE $ 'ICS
July 1,2010,until June 30,2011. TOTAL PERMIT FEE $ EX*
The minimum surcharge for a"fixed fee"permit ►m
is 55,beginning July 1,2010
This Application Becomes Your Building Permit When Approved Paid r s.0 Rec No. l X03
Date
i ( ... i,1 B
Buildine Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372