HomeMy WebLinkAboutMechanical Permit 13. 1167 for LLF 13. 0797 ,
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4 rRro CITY OF PRIOR LAKE Date Rec'd
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Ay, HEATING/AIR CONDITIONING/FIREPLACE PERMIT 10, 2_/, /3
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IMNESpo I.Pink File
x.crew city PERMIT NO. /5,//6/2
1 3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
/6-2—C 1 (0,10 11 Si5 6lIolk(A,CiA-f W 0
LEGAL DESCRIPTION(office use only) � ,
LOT ( }}dC
LOCK f ADDITION f `e 4)c(�C/ 2 il'b / A,60/V) PID 47 ' ,1"e/e-o
OWNER
(Name) ��tir l 1656 Mal") (Phone)
(Address)
APPLICANTS f _ 2
(Name) 1 tet* C ave h ZDe44/ll. "c f .1-t,•--c, (Phone) (/Z-- �C)( 7 04-067
(Address) 7----t4A-C- �ht.alioi 1 a l)i• Ii o4- k Sc't 7 L_ .
ress) (City) (Zip Code)
/ l
(Contact Person) ' P( tf (Phone) �._ b44glA,
APPLICANT SIGNATURE 44,‘,0 DATE l0 Z—( /.3
APPLICANT PLEASE COMPLETE BELOW
:NEW CONSTRUCTION 0 REPLACEMENT ,'ALTERATIONS •
( (41.0, 1T•
FURNACE MAKE AND MODEL Il
. ' ) Vep CQ < FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
['Warm Air Plants 0 Steam Units and Fireplaces Cannot Encroach
QGravity 0 Hot Water
Q Mechanical 0 Radiation into Required Side Yard Setbacks.
QAir Conditioning 0 Special Devices Fireplaces with Box Additions or
DVent.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 $49.50
Estimated Cost$ Building Permit #
,/
The Minnesota Statutes§326E1.148
HEATING PERMIT FEE $ ,S® "SI RCI IARCiy"has been changed for one
4
near effective
STATE SURCHARGE $ , , 0 ii July I,2010,until June 30,2011.
TOTAL PERMIT FEE $ , 0 'the minimum surcharge for a"tiled fee"permit
(Office Use Only) — is K,beginning July 1.2010
This Applicationt ��-. (Becomes Yo wilding Permit When Approved SO Receipt No. /
CIX- l D, 2-(, �3 ate ` By
Sandhi!Official Date � 21- (3 —
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372