HomeMy WebLinkAboutMechanical Permit 12, 1089 m ❑ ❑'. 0 00000 0 - 0 0 > z0
m 00 0 0 0 o )m-TO O z 0 m
°
ft, 73 0 m zr� m N ��
>a 0 D Z o zo
n'1 ` " _� N m z = Z 0
S 7 0 o 0 m
0>0 3 � � m
m pl
71 13 TI
0 0 _ --- .\ K❑❑D❑❑ 1
Z m m m 3�N >3� ■
C
c c
- ° ° ! i 3 m = 3 -o 0 C 0)
o p v m c — ' 'zx =73z m 0 m
> 0 3 _ rn
m 0 r -n OO xi -1
0
o z Zcc z C
r
0 Z
11 0
ilk I OD
X 0
c 0 ��
m ❑❑0000
O❑ - nnm
R` D z C' V O ` � m
D m n n -
4 n Dmm�
m �° •" r
cn > Z m
—.4 r 0
((v,R.104 CITY OF PRIOR LAKE Date Rec'd
HEATING /AIR CONDITIONING /FIREPLACE PERMIT
H
,. 1 . Pink F PERMIT NO. / L. /o rr
�1�'NESO 2. Green C ity PERMIT 1v
3. Yellow Applicant
(Please type or print and sign at bottom)
DRESS ZONING (office use)
- S fferrcil St (W F La K?
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER WO a (Phones 2 lV
(Name) { yy � )�/ �{
(Address)h7 �' 1 / O l l 3 Y WW Frio( Law 5 ° 7 2
APPLIC n ��VI���I -VII ��l� I � J
(Name) . I ►) ( P one)
(Address)
(0 Cfld eit61 td Rol . ��
U (� (Address)
ri (i (Phone) J J
(Contact Person) 1
APPLICANT SIGNATURE � A —1 ,.�i. \ � / ° DATE Arl "c:
APPLIC' T PL s . E COMPLETE BELOW
['NEW CON TRUCTION /�` EPLACEMENT ❑ ALTERATIONS A i
FURNACE MAKE AND MODEL l ,a1Y4./Y FUEL ,q,�
1 V t/ v
FLUE SIZE RETURN OPENINGS INPUT O OUTPUT ` ( Wu
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
DGravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation Fireplaces with Box Additions or
❑Air Conditioning ❑ Special Devices Cantilevers to the Outside of Buildings
❑Vent. System ❑ Other Devices
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 Cost $ Building Permit #
"SURCHARGE" has been extended
until June 30, 2013, HEATING PERMIT FEE $ re
The minimum surcharge fora STATE SURCHARGE $ 0
"fixed fee" permit is $5M0 TOTAL PERMIT FEE $ P I�ii'17
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid j -_, ` 7 /Z By ,� 7) Receipt No.� Id 9 ,. —
Date oil /2_ 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