HomeMy WebLinkAboutMechanical Permit #12-1359 y ❑ ❑�. n ❑��000 = � o N�
� n n O u,�Z�no� o v �
n n � o°� 3�z�n�° m m m mo
b A o � � � '3i r = � y .
� � m m y Rt y �ZDZ O tn O�
� � � 1 - m ���� = O
t0 � ui V1 � Z z p�
� � _ > o °z � "�' �
� m
� o � z � �
� � � p � �
� ,� � v
� z � � � � �jl,❑❑❑o❑ 0
'� x m m m m�
� z '° o o ���� � m p � c
� C � c�'o � � D� 3 Z m
� � r i� O O � -1 � �
�� o ° z z�� z C �
�° z � m � �° �° � � o
� A �
� 0 m ,�\
� C O lv �
N m ❑DOODO N
`y Z � ,n ?f ?1 � � � '� >
R�. �' � ymm� � ( m
o r�v�� W 1
� Z m���o
� m ��+��� �
� � z- � m
D
H� 2- c��31 �� ����-� S�
4 PRip CITY OF PRIOR LAKE Date Rec'd
� �� HEATING/AIR CONDITIONING/FIREPLACE PERMIT
� x
� �
�INNESO�� t. Pink File
2. Green City PERMIT NO . /��, / ./��
3. Yellow Applicant
lease or 'nt and si at bottom
ADDRESS ( ] � � . �'^ i A � `n � ZONING (otleice use)
)!� Y� �� � t �i r�: ��
LEGAL DESCRIPTION (oflf'ice use only)
LOT BLOCK ADDITION PID
OWNER � I� I
(Name) �O�' (Phone) � L �V��D'-t ��
(Address) J � Q � C
APPLICANT 1' � � / �� / �
(Name) Phone) �
Address � �� � � w � � � �� � � J ��
� > Z / Yl S�� ( (� �]
(Address) (City) (Zip Code)
(Contact Person) � (Phone) J � �� '
APPLICANT SIGNATURE DATE � I I
APPLICANT PL AS COMPLETE BELOW
❑NEW CONST UCTION REPLACEMENT ❑ ALTE TION �
FURNACE MAKE AND MODEL ^ G� �- lP`I `'`^� � O� FUEL �
FLUE SIZE RETURN OP INGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
,�❑�C avity ❑ Hot Water into Required Side Yard Setbacks.
��N�echanical ❑ Radiation
LJA Ir Conditioning ❑ Special Devices Fireplaces with Bog Additions or
❑Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEESCHEDULE
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
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
Estimated Cost $ Building Permit #
HEATING PERMIT FEE $ • � v
STATESURCHARGE $
TOTAL PERMIT FEE $ � ,
�ot��e use oniy>
This Application Becomes Your Building Permit When Approved Paid :�-�1 Receipt No. � � L /
U (�
Date /� / , / /� By
Buildine Official Date 7
24 hour uotice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372