HomeMy WebLinkAboutMechanical Permit #12-1180 3 0� n ❑OO�❑❑ � O > Nc�
n �� o 0 0 3-�`�y$�$ ��� m�
p D o ��� 3 m �c3z-� m � y �'n
� � , m m y m y sz p N p�
�
l'�n �: "� � - -� m � � p Z �
c m n T N� Z = O
�''° ° � � � Z �^ m
z -�
� O >Z�° O �C
� F v � M
� � ,��� � �
� � �p �toaoo❑
m m m m l 3�o�n�;�
�- y v v � �c s�c
�e � =m��x� m n H
z �
p rs m �- �- v O A
C m � � �'�i = C�i 3 � m
� � o z � r � ���� � z c
o z fi � ��� ° v
� A O _
� = m
c
� � < aaaao❑ �' O
N
Z �L 41 'tl C1�
A. v A C ���6, ) f�i
� Z " �� �
� m �'����
� � � �, � �
�
�� PRIp�� CITY OF PRIOR LAKE Date Rec'd
�
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
v �
�I�'NESO�� �. P+� File pERMIT NO
z. cneen c��y �
. . 3. Yellow Applicant �
lease e or ' t and si at bottom
ADDRESS ZONING �at��,�>
1 JW
LEGAL DESCRIPTION (oflE'ice use only)
LOT BLOCK ADDITION PID
� n �� f I.�VI�,1► YC (Phone) �D � O' " i I �� IJISJ�J�
\C.�_)��v
(Address) 3�� � ` �,(� , � �
APPLICANT BURNSVILLE HEATIN� � �,lC INC. n (', ��y�` �
(Name) (Phone) "LSZ � `� UC�(�
. �
(Address) 3 "�"� ' ��
�����r� P (City) (Zip Code)
(Contact Person) l �� (Phone ��
)
APPLICANT SIGNATURE DATE 1 C��' �"I �
APPLICANT PLEASE COMPLETE BELOW
�NEW CONSTRUCTION �REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODE � (� FUEL S
FLUE SIZE '� RETURN OPENINGS 2 INPUT OUTPUT LSZ.C�J-s��!
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑ Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
� Mechanical ❑ Radiation
Air Conditioning ❑ Special Devices Fireplaces with Boz Additions or
❑Vent. System � Other Devices C�� , Cantilevers to the Outside of Buildings
P' 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 Conshuction) $64.50 Residential, AC Only $49.50
The Minnesota Statutes § 326B.148 '�ost $ Building Permit #
"SURCHARGE" has been extended
until june 30, 2013, 3EATING PERMIT FEE $�{� �`J�
The minimum surcharge for a iTATE SURCHARGE $ �.�
"fixed fee" permit is $5.00 COTAL PERMIT FEE $��. �
-- — . _
This Application Becomes Your Building Permit When Approved Paid� � R ipt No� -73 �
Date �, s �
Buildine Official Date •
24 hour notice for all inspections (952) 447-9850, fas (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372