HomeMy WebLinkAboutMechanical Permit 11.1336 VRIO CITY OF PRIOR LAKE Date Ree ' d
�� HEATING/AIR CONDITIONING/FIREPLACE PERMIT
�'jMvES��P " \ ' Pink PERMIT NO .
Green 2 Green C,C,,
3 Yellow Applicant Y 7
lease type or print and sign at bottom
ADDRES 4> ANC6� ZONING (officeuse)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
8 Z uU^<alO - eS -
APPLIC
(Name) G�•I nY� I A w► l/LI }tom Ut) n (Phone) ?) - q J 5 Z Z �o
(Address) L5 L_ 1" �. �/1 VnnN4,lil film c35g4j
(Address) (City) '' (Zip Code)
(Contact Person) ku (Phone)
APPLICANT SIGNATURE DATE Z Z - 2 (t (/
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ❑ REPLACEMENT VIALTERATIONS
FURNACE MAKEANDMODEL _ 12 Di %5q p Awl f0 4 X I n o FUEL
FLUE SIZE 3 RETURN OPENINGS INPUT � b t 00f) OUTPUT Z . V 0 0
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warn Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water i
E] Mechanical Radiation nto Required Side Yard Setbacks.
❑ Fireplaces with Box Additions or
❑Air Conditioning ❑ Special Devices
[IVt. System ❑ Other Devices Cantilevers to the Outside of Buildings
)( [ a V. Ail Require a Building Permit.
FIREPLACE MADE 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
n
costs 1101 6 d t) Building Permit #
The Minnesota Statutes $ 32613. 148
" SURCHARGE" has been changed for one HEATING PERMIT FEE $
year effective STATE SURCHARGE $ .50 C/
July 1 , 2010, until June 30 , 2011 . TOTAL PERMIT FEE $ 30 ZS
The minimum surcharge for a "fixed fee" permit l
is S5, be innih July t , 26111
This A���ic� `on Becomes o $uilding Per l it 'VVhen Approved Paid ) Receipt N
DateBy
B Odi a Official Date 1 -
24 hour notice for all inspections (952) 447-9850, fax (952) 4474245
4646 Dakota Street S.13., Prior Lake, Minnesota 55372