HomeMy WebLinkAboutMechanical Permit 13. 1299 for 13. 1308 , -#- /&33q5 52/. 00 ,
: ,PRIG CITY OF PRIOR LAKE Date Rec'd
a° HEATING/AIR CONDITIONING/FIREPLACE PERMIT
4ljNNEso° I.Pink File PERMIT NO./3IL,2.Green City 7 j
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESSS- �� r ZONING(office use)
c9e t ''V
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
O(Name)R t`J/ 0A/c.
l/LciO-a-r-1` / 4---eg (Phone)
I (Address) ! / s Fdylj{ 1CL e'v PricytI
APPLICANT 6_1)--)C4 - Ile'
' cei.2)-19 ci /4h17 (Phone) &J/ —4/S-))—U '2a /
(Address) 60Q actrdmaf1 I e' Art J. E / .61-(.CX Ss-0 -7S
(Address) (City) / (Zip Code)
(Contact Person) �a y��'`� 6(/) .- _g (Phone) (O 6/ — S� U Co2 f
APPLICANT SIGNATURE ‘.41,(.."721 ( . gm, DATE A 1/ a`//3
APPLICANT PLEASE COMPLETE BELO
❑NEW CONSTRUCTION ❑REPLACEMENT ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
['Warm Air Plants ❑Steam Units and Fireplaces Cannot Encroach
❑Gravity 0 Hot Water into Required Side Yard Setbacks.
0 Mechanical 0 Radiation
❑Air Conditioning 0 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 $49.50Z� / G�e&)
/ �v F,stimatedM Building Permit #
�� C The Minnesota Statutes*326E3.148
"SURCHARGE"has been chanced for one
qCO l i HEAPERMIT FEE $ y . �� year effective
STATE SURCHARGE $ oJuly 1,2010,until,l June 30,2011.
q V� TOTAL PERMIT FEE $ t So The minimum surcharge for a"fixed fee"permit
is SN,beginning nning.l my 1.2010
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid S3,.-4 J V Receipt No. "c33
Date
Building Official Date /OW BK1.
A.,,,
C_/ •
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 1
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372