HomeMy WebLinkAboutMechanical Permit #12-1422 ; ❑ ❑� n DOOOOD � O > Zc�
� � �� O u,,,=�,,,� p � ° v ��
n c� � �� � 3 ���';°co m m m mG
� � � � m y � y 0 � vi ��
e� � A � - m ��={� Z O
b � D tn y n Z Z Z�
S � � � a � o
� o �DO z m�
M O > Z �
� � r � �
o � �
� _ � � � �:oaoaa Gj
'� � m m m 3 ���;�
o� a N v o �c ��c
�c =���_� m � �
� c � � � ` A� � � m
� ° c
� � o z �r-„g� � � -
b •
� _ � � ��� O 0
� = n�i
� ^ O � 1
C
� y � 0�00�0 I �
� Z z ���p� �
� D � ������
>
� Z ;mm�� � .
� m �o„�0�� �
� � cZi
��. S� �ci-��`3�73oZ
� rRlo CITY OF PRIOR LAKE Date Rec'd
� � � HEATING/AIR CONDITIONING/FIREPLACE PERMIT
v �
�jN1VES��� 1. Pink File
2. ��„ �,�. PERMIT NO. �L-It�CLZ-
3. Yellow Applicant
ease e or ' t and si at bottom
ADDRESS ZONING (oflflce use)
� �r
LEGAL DESCRIPTION (oflEce use only)
LOT BLOCK ADDITION PID
�aWNER I"1�� �.��C�1� (Phone) �'�,SZ'�T T� � Jl�[��
(Address) 3 � "�
� PLIj T ` � ) t �,J?�� I ' � �� �
ame � hone
� 4 /a
(Address) � �J
(Address) ( i (Zip Code)
(Contact Person) (Phone) � `�
APPLICANT SIGNATURE DATE �� �
APPLIC T PL SE COMPLETE BELOW
❑NEW CO STRUCTION REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL 7 C FUEL �`
FLUE SIZE RETURN OPENINGS INPUT �� WUTPUT �
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
Gravity ❑ Hot Water
echanical ❑ Radiation into Required Side Yard Setbacks.
❑Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
❑Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
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 Constnzction) $64.50 Resi@ential, AC Only $49.50
The Minnesota Statutes § 32GB.1*�8 �ost $ Building Permit #
"SURCHARGE" t�as htien ex�ended �O� _ �
����iti� ��u�e: :�i�,'�U1.3, HEATING PERNIIT FEE $ �
� 'Che n�ini�nutn �i�rchar�e for a STATE SURCHARGE $ { .� (� � �
°'fixe�i fee" permit ►s $5.t)(3 TOTAL PERMIT FEE $ C�,�. .�(�
This Application Becomes Your Building Permit When Approved Paid T -�� Receipt No. �� 2 /'
�7 �J f9
Date % � / `Z � By
Buildin¢ Official Date �f
24 hour notice for all inspections (952) 447-9850, fa$ (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372