HomeMy WebLinkAboutMechanical Permit 13. 1004 C) 000000 1 o a E
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PRIp CITY OF PRIOR LAKE Date Rec'd
O�y'tx�.'Fiuq'f�
�y 4,u� � ATING/AIR CONDITIONING/FIREPLACE PERMIT •
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P 973 , S :
PERMIT NO.
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I.Pink File
2.Green City /� //�n 2/
3.Yellow Applicant s �s C�
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
k V31 N a ( a, (t,‘e_.. ►Q-at `" E- ii i
LEGAL DESCRIPPTION(office use only)/ i
LOT BLOCK ADDITION PID 075- / 24-Do7q-O
OWE(Naame)R on Q_Q-L`.r\-€✓ k - Q \p‘ (Phone) ( (2—Li i2- t 7 to
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(Address) kL1 2 o ( u o. &11, .e_ L K)-E
APPLICANT()
e) �rp,.>l� III . , i f, _ (Phone) 9Sz. g' S--7r)--7—)
(Address).1 bill . A k*n.K A L S ff ' it 1 i SSS l
(Address) (City) (Zip Code)
(Contact Person) / • (/V (Phone) S ovrnl2.__
APPLICANT SIGNATURE , ��, DATE t:/ el I
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 1RREPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL T'URfiI MAI t. Ct2 1) -(Zo 4 C. FUEL 'ea cS
FLUE SIZE RE OPENINGS INPUT fczr3,,OC>O OUTPUT S—.), 60 b
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air Plants PLEASE NOTE: Air Conditioner
❑Steam Units and Fireplaces Cannot Encroach
❑Gravity ['Hot Water into Required Side Yard Setbacks.
Mechanical 0 Radiation
Fireplaces with Box Additions or
&kir Conditioning 0 Special Devices p
❑Vent.System ❑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 $49.50
Estimated Cost$ T7OL. CO Building Permit #
The Minnesota Statutes§32613.148
HEATING PERMIT FEE $ .//q1 ® "SURCI liar been changed for one
/� year effective
STATE SURCHARGE $ � 0 ,July 1,24110,until June 30,2011.
TOTAL PERMIT FEE $ ) The minimstu•churge for al"Pied fee"permit
(Office Use Only) 7 r ius m 5,beginning,July 1 ,2010
This Application Becomes Y. i r Building Permit When Approved ipi t) .te1 Receipt No./J)014
i; ( v
A t 13 ' n ate By
1ridineOfficI• Date / ) 3 ��3
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372