HomeMy WebLinkAboutMechanical Permit 13.0685 _
ia
z 10
LL= U U a Z W
25
aaa O p
cl o ` W ti0 W — [.
N
v O
w =
u. N O
O O n J W z
• - z _ Y Y Z \ z o O w
a c2 H a' OOLLJ 0 0 I c V U 4
Q r P p`j w c
V O W CC = — =sZZ U c a
w ...il v a m a 0 z
gw4 _Jw w w z F- p
a. 2 cn a 2 \ U U W Z � ? ` zC�
a a c+.
o = Q o
Q
U
Y0 o LLa co
o
0 0 o c A u ' 0 3 °'
a� cn O _0 - z W � w w w
LL ►- u) z f - z2 S rt w o p
a 0 z 0012(47.Z/- . )i 0 3 0 0 c
5z < O m 000000 0 ,0 ❑ —
1
rRtp� CITY OF PRIOR LAKE Date Rec'd
4,`",',W - HEATING /AIR CONDITIONING/FIREPLACE PERMIT
N r , Esoo r 1. Pink File PERMIT NO (�
x. Green City ® 4 Y
1 3. Yellow Applicant /3 O
( Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/ / _ (I ii (4 r, Z-.-) l l of L /' c, i" ,v c> 5 372
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER ,,f �J
(Name) /Jo/c� C cJ / Y (Phone) •
(Address) / Li 7 `7/ (4r r / ,3C_ L4 1 /'l (9r Ii/ lc., nxi .5 5 7 3 .
APPLICANT
(Name) i 5e r v l /c. G> Ce9 /' '1p 4 1 L L (_ (Phone) / 7 — .`7 q 7 ' ,2 c� t ,
1 El •
(Address) / WV 7 4 4 /O/c, 6/ G Pier. /P c./(..— S' q u' er,C , 5
(Address) (City) (ZAP Code)
(Contact Person) - r (Phone) 6 / " ,7 7 - ,2 ,2 (g5
APPLICANT SIGNATURE 1- �,-- DATE " 2 <) — 2 0 /J
APPLICANT PLEASE COMPLETE BELOW
ANEW CONSTRUCTION gREPLACEMENT ❑ ALTERATIONS •
FURNACE MAKE AND MODEL PC.t7"c__ / q X n 'f f 8 2 g6 FUEL
FLUE SIZE RETURN OPENINGS INPUT e , Cc,c OUTPUT 73 0 ea
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 Fireplaces with Box Additions or
DAir Conditioning ❑ Special Devices
❑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
Estimated Cost $ Building Permit #
The Minnesota Statutes * 32613.148
HEATING PERMIT FEE $ "SURCHARGE" has been changed for one
year effective
STATE SURCHARGE $ .50 .Jahv 1, 2010. until June 30.2011.
TOTAL PERMIT FEE $ The minimum surcharge for a "fixed fee" permit
(Office Use Only) ,..15 ,..15„ beginning July 1.2010
This Application Becomes Your Building Permit When Approved Paid �, / �� Receipt No. 3 '
7 f� S
Building Official Date Date kb_ —7)) 3 By
24 hour notice for all inspections (952) 447 -9850, fax (952) 447-4245 ,"
4646 Dakota Street S.E., Prior Lake, Minnesota 55372