HomeMy WebLinkAboutMechanical Permit 12. 1467 3 ❑ ❑ C1 00000 0 z % D Fi
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„I i 0 CITY OF PRIOR LAKE Date Rec'd
fto ; 7_, HEATING /AIR CONDITIONING/FIREPLACE PERMIT
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`Elf l �'** t. Pink File
MvES 2 inn„ city PERMIT NO . 1/2-N-6 I
3. Yellow Applicant 1
(Please type or print and sign at bottom)
ADDRESS G ' ZONING (office use)
1(-1 6 ( w : (( v, 6..m
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
((Name) I allot, I ,( i (Phone) O /04 - � c> r°.-) - -- `� / /69 .
(Address) ) l , / ) :a Ui`eL.,E f r 1 7� r L� - � 4/ � �' .J 70�
APPLICANT ae),/tywylm.ravlicitY1' �, �'r / /
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(Name) /�u Gv� ° C �` U- i O (S (Pho ne) (c , / 0( '• 01 6 0Z (Address) J f �. / !/ ; ✓l 1� at �� l b Sa-Vi .
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AAddress) / (Cit (Zip Co
(Contact Person) / " t- C.1 dU (Phone) 670t.-K4 \ )°1
APPLICANT SIGNAT ' • DATE r.- - C
APPLICANT PLEAS OMPLETE BELOW
:NEW CONSTRUCTION REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL � 'd(> C (/.--, TtroZ i 1,311f Ye) 7 FUEL 699 i - 5
c.. FLUE SIZE _ RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT .
v PLEASE NOTE: Air Conditioner
t ['Warm Air Plants
❑Gravity ❑Steam Units and Fireplaces Cannot Encroach
❑ Hot Water into Required Side Yard Setbacks.
❑ echanical ❑ Radiation
4 Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
'J ❑Vent System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
C>.--- FIREPLACE MAKE AND MODEL
(--- • FEE SCHEDULE
Industrial, Commercial & Multi- Family I% of job cost Residential, Gas Fireplace $49.50 •
---------- - -- - -- $49.50 minimum
Residential, Heatin. & A/C -w ...insult . t t '' $149.50 Residential, Additions & Alterations $49.50
Residentta , • eating Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ / XZ Building Permit #
/ The Minnesota Statutes `s 32613.148
HEATING PERMIT FEE $ 'I° 5 - 6 "SU "S( RC JAMIE" has been changed lor one
year effective
STATE SURCHARGE $ S` — .filly 1, 2010, until .,June 30, 2011.
TOTAL PERMIT FEE $ 7 y � w The minimum surcharge for a "tiled fee" permit
(Office Use Only)
is 'S, beginning July 1.20111
This Application Becomes Your Building Permit When Approved Paid j t I , st Receipt No. z t/ 3
BuildinE Official Date Date , / �� i / 2- By )
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372 •