HomeMy WebLinkAboutMechanical Permit 13. 1153 for 13. 1225 • 04 r R'o CITY OF PRIOR LAKE Date Rec'd
,, e HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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li3.Ih'NESo�� `.rGr'a>ieen rCitey PERMIT NO.
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1 3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
•
LEGAL DESCRIPTIO (office use o )
LOT 41.54-&-- , frig ITION PID 1,---/L//' '%c9—
(Name)OWNER YVI 6 l" I Ltel.utl (Phone) 6 ”-- -.(9- 1--7e,‘
(Address)3i/.40 i3L)'t{ -ra ti /c I&AJ vtir f r .L.-.,, I.euc r ,,44 rt) >�< '7 —
APPLICANT
(Name) ..._77,_ (Phone)
Cent acre'
(Address) .,;as;Cotiomotiwit.14c.
7'
lit.ii Y. (City) (Zip Code)
as • on Avenue
(Contact Person) Eden Prairie,MN 56344 (Phone)
941.1044
APPLICANT SIGNATURE 1A DATE _/e, — 7- I
APPLICANT PL ASE COMPLETE BELOW
ONEW CONSTRUCTION ❑REPLACEMENT 10 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
t PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑Steam
['Gravity Units and Fireplaces Cannot Encroach
❑Hot Water 1 i{ J�� iq
nto Required Side Yard Setbacks.
❑Mechanical E-Radiation i
Air ConditioningFireplaces with Box Additions or
❑ ❑Special Devices s Cantilevers to the Outside of Buildings
❑Vent.System 0 Other Devices g
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 $49.50
Estimated Cost$ (f ,2 e',L Building Permit it
The Minnesota Statutes**32613.148
HEATING PERMIT FEE $ t;( (/ r 50 "SIiRCI 1ARGy"has been chanced litr one
year effective
STATE SURCHARGE $ 0 a.% July I,2010,until.lune 30,2011.
TOTAL PERMIT FEE $ The minimum surcharge for a"fixed fee"permit
(Office Use Only) ` 0 is_5,beginning July 1,2010
This Application Becomes Your Building Permit When Approved Pai i . .._.yl Receipt No. zuo /
Date /x ,I(///� 43 By,Building Official Date , _4_7 �
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372