HomeMy WebLinkAboutMechanical Permit #12-1456 y o o � n❑aoaoo = o o N�
,� � 3 -N-i�t=i�Too = � , m
m�c� � „
b �� ° � m 7�C rn y p y ��
De r - -�i > Z � 0��� Z O
p � > y � N � Z z � o�
� � 0 �5
�° o � z- � Z m m
t� O > � �
� a
� � r � � ro
-�
�, m � o � �000❑❑
t� Z � n ;�otn���
� x m m m nC�-��in
�" � � � � = o�o m= W m n n
� C � � � �' � yc� O�c� 3 � v
De m � � � r�00 � =1 C
� � o z (, ycc = m
�° z � m t'" ��� o v
� A � �
o m
n
y c ❑❑�o0q � ....
m ��n l C �
� Z Z �70�OZ` m
ymm3�
R. 0 4� r���v
� a.' D m nn sv
� mm�
� m ��� � �
� � � — � m
4 P RIp CITY OF PRIOR LAKE Date Rec'd
° �� HEATING/AIR CONDITIONING/FIREPLACE PERMIT
� �
�jNNES��P L Pink File PERMIT NO .
2. Green City �L �,. /� �
3. Yellow Applican[
lease or ' t and si a at bottom
ADDRESS ZONING (ofl� use)
��7�-� ���� �r� �� �l�r t��-�
LEGAL DESCRIPTION (o[�'ice use only)
LOT BLOCK ADDITION PID
OWNER 'f -- ��/J L.,�
(Name) ' (Phone) ( � - �
(Address) ��� rr �r� '� ��� �� / �
(Name) 1./l � Il �:�.J! 1 l �" I � (Pho ) � � ° i ✓ �
(Address) ������ 1���� � ,�"�� _
(Address) (Cj,t�._�
v � ` � � ��
(Contact Person) (Phone) �
APPLICANT SIGNATURE DATE
APPLICANT LEA OMPLETE BELOW
❑NEW CONSTRUCTION REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL �Y �J�N ���"�) �JV � FUEL
FLUE SIZE RETURN OPENINGS 1NPUT � OUTPUT
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 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 Construction) $64.50 Residential, AC Only $49.50
The Minnesota Statutes § 326B.148
"SURCHARGE" has been extended 'ost $ Building Permit #
rz��tnl jurie 30 'lQ L3,
The minimum surcharge for a 3EATING PERMIT FEE $ �.
"fixed fee" permit is $5.00 iTATE SURCHARGE $ .50
lOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid �i/ � Receipt No. � �
7
Date ! , / / By
Buildin¢ Official Date �)� ��
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372