HomeMy WebLinkAboutMechanical Permit 12. 1275 3 0 ❑ X C) 00000 0 13 O > E
Ul
0 0 O m -n TT = 0
p n o X 0 0 3 rn>c C0 Z 73 m n0
r A T
to
CI r o m m ` m 2 bk Z O 1p 0 O
-- 4 a - m � Z Xi
ro u) z ° z 0
3 ' O
ti
Eli o O 0 0 t� z i � 1' \ n 7C z -4 m 1 \k \` ( m
v5
• Z O li 9 ❑ ❑ ❑ ❑❑
..,1 m m m m ��� r 3 � CA *C13
* N O m 0 \- 0 C 0 C
= = -o c) to
a m - 0 \ , Z - 00 � Z 3 _10
m
)
_ p 0
O W a cc Z ' m
o Z .. m N I r -0 -0 0 m
• A 0
0 m
� ' N 0
c - m / ❑ ❑ ❑ ❑ ❑ ❑ v
y Z O 71 11 0 m
z > 0 � -'
• 0 \ , r-m0- p0 m
�, m v
hi 0 • z nn �, F r --I
rn ,, — m m _, v , R
r ,"
, P M R� o CITY OF PRIOR LAKE C' Date Rec'd
'� � HEATING /AIR CONDITIONING /FIREPLACE PERMIT Niit ) 0 45-1)-
�JnNEScro. I. Pink File
2. Green City PERMIT NO . ( I
1. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/if/ 9 7 ( 4O/C-C` ,4--( n9 e- -----
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
APPLICANT
(Name) f 0 so L-(!7 / fC/fi1`Ji (. f LLC (Phone) ,5 . /
(Address) 7.73E5 c2/ivfJ ti LA9 :-_- p/A, <" /it /L` Flre7 5 --- . -- (pi)
(Address) ity) (Zip Code)
9S .3f3 — c- 776
(Contact Person) ti,... wg.+,, - (Phone) ( 15 - 2-- k3/ —600/
/
APPLICANT SIGNATURE _ / ' _ DATE A -7 2_
APPLICAN' LEASE COMPLETE BELOW
❑NEW CONSTRUCTION PLACEMENT E
FURNTACF MAKE A M QEL 7Z[19j bi_i Cc4-.( FUEL
FLUE SIZE RETURN OPENINGS INPUT 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
DAir Conditioning El Special Devices Fireplaces with Box Additions or
[Went. 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 $ Z / vw Building Permit #
The Minnesota Statutes § 32611.148
"SIiRCI Ir1RG" has been changed for one
HEATING PERMIT FEE $ 1/ 5�
r year effective
STATE SURCHARGE $ 5 JO .luly 1, 2010, until .June 30, 2011.
TOTAL PERMIT FEE $ y, 50 "file minimum surcharge for a "fixed fee" permit
(Office Use Only)
is ,S5, beginning July 1.2010
This A placation Becomes Your Building Permit When Approved Paido Receipt No.
/0— 'S-- /Z Date /. ] By
/ ne Offi ( Date t/ -d--f ]f- re«
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372