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Mechanical Permit 12. 0248
5 0 0, 0 000000 - 0 0> 20 k 0 0 0 2 - §�o� Z m k M k r n 2 2 7 - z § 2� r ■ `13 "- - p o 7 k * 3. k 0, 0 0 0 - � S. 0 j . ,. z ■ $. zo mm 2 x' F o < i Z k0% , 000000 § X El2 m Ev *E m r` E § °° i n� 2 -1 9 7 2? ■ m ■s m 0 ■ § - = o 2 z77�Z Z z z , 70 -0 e Q f m 0 0 0 111§§ a 2 % z / .� o 0 2 . C • § . �� 1 . X 13, .Roo00 o 0 s ,mmo P / g o �.c����\ A • Z . © C tl c1 § � q �■ � F § -I 0 k - tZ- I'--i 5 gi c_ 5 pRIO CITY OF PRIOR LAKE Date Rec'd �°' " '� HEATING /AIR CONDITIONING/FIREPLACE PERMIT Z5 44 ,--=,-.1344H.,,,, 1 til/ (Z_ , 2/1 7 41NNNESO° 2I. PiGreen nk p Ci il t e y PERMIT NO./ 4-0 1. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) \ 29. t Par b r C S LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID (Name) - pc l (Phone 1 ' l J � (Name) (Address) APPLICANT a me)) _ii - 1. • a (Phone) S 2 _ 7 (-l% 1 1 LJl ) (Address) � . W\ P 1 (/L4 1 t SS ? 131 (Address) (City) (Zip Code) (Contact Person) Pi ( A. i A �_ (Phone) q S 7 :7 Lo -7 " (W Q APPLICANT SIGNATURE J l ' I*. DATE / 1 APPLICANT PLEASE COMPLETE BELOW I i' 6(} (jj ,' ANEW CONSTRUCTION ❑ REPLACEMENT ❑ AL ' . " i ' '1.." FURNACE MAKE AND MODEL ' FUEL FLUE SIZE RETURN OPENINGS INPU�UTPUT - TYPE OF SYSTEM HEATING OR POWER PL ... ............. . PLEASE NOTE: Air Conditioner DWarm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach ■ G ity ❑ Hot Water into Required Side Yard Setbacks. r Mechanical ❑ Radiation II Air Conditioning 0 Special Devices Fireplaces with Box Additions or DVent. System 0 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 & AJC (New Construction) $149.50 Residential, Additions & Alterations $49.50 Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50 Estimated Cost $ Building Permit it The Minnesota Statutes * 32613.148 HEATING PERMIT FEE $ "st1RC 1 I ARG ye has been changed for one year effective STATE SURCHARGE $ c — AG' July 1, 2010, until June 30, 2011. TOTAL PERMIT FEE $ j. 09 The minimum surcharge for a "fixed fee" permit (Office Use Only) is Sf, beginning July 1.2010 This Application Becomes Your Building Permit When Approved Paid U U Rec No. (P 5-,p5/3 Date ` - / 2_ A Building Official Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372