HomeMy WebLinkAboutMechanical Permit 12. 1252 J 4,
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PRr CITY OF PRIOR LAKE c / Date Rec'd
l HEATING /AIR CONDITIONING /FIREPLACE PERMIT
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2 t. Pink n P Cit ile y PERMIT NO. /2 _ /251—
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3. Ycllow Applicant
(Please type or print and sign at bottom)
ADDRESS LO Nd / T ZONING (ctticc use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER ` ( I
(Name) �1 \ rt 1. _ _ (Phone) __ I
(Address) 5a 1. rr �' ; •
APPLICANT
(Name) SEDOWICK HEATINr, R OR CONDITIONING LLC (Phone)
1408 Northlaii^ _)ri = Suite 310
(Address) MendotP H, '- 'J1N 55120
( -3000
(City) (Zip Code)
(Contact Person) 0 Ali (Phone)
APPLICANT SIGNATURE 411,111E. I DATE / 1/1/1_,2
APPL !ANT PLEASE COMPLETE BELOW
NEW CONSTRUCTION OEPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL 2 r f'l Y C T`O`oroV I ( C tif 0-‘*6■, FUEL
FLUE SIZE RETURN OPENINGS INPUT ) 0 U () OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑ vtty ❑ Hot Water into Required Side Yard Setbacks.
Me chanical ❑ Radiation
❑Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
❑Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
I Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi- Family I% 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 $ (,Q L) , - 62 Building Permit #
y
�-7 The Minnesota Statutes * 326[3.148
HEATING PERMIT FEE $ 9'. J t_J SURCI IARGe has been changed for one
year effective
STATE SURCHARGE $ <i C.., 4158 Jule 1, 2010, until June 30, 2011.
TOTAL PERMIT FEE $ � " The minimum surcharge for a "fixed fee" permit
(Office Use Only) f k 8. beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid , /, Receipt No.6 7 V6.. -
Building Official Date Date / d / � i. By , 4 ,
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372