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Mechanical Permit 12. 1152
J 0 w Z _ Z H J u- lL K W 4. N u ii id C> W °g ggz z 4 a aaa� > . c �2 wwu� c� A IL Q o W ° U u ti C7 Z 6, 0 = o w = cc gm./ ..n 0 N nr 0 �, O >> 4 W c O Lx D it r i F- 2 O O u, J 0 U U n. W F- 2 O 000< f- a� W j ti x Z p' Z =2=Zti W c y co U 0 w a m = Wre n = 1 w A Z ,, a. = ` 38 Q 3w .t 0 o z 1 p a 2 ' w w w w �` 1,1\❑❑❑ ♦, o o w Z 'J a a ° _ 0 LP J p Q ; LL p`i W 0 Z U O _ z 0 u. V O ..."\.. a j u O z 0 0 z w F- ~ �- 1.-- n 01 E a 6 co z o? ~ = W ` w w W Z g O w w z � M � ui z F w O v V 1-0. o 0 OO = Z LLN 0 3 o 0 0 U? Q 0 a 0 ❑❑❑'❑ 0 ❑ ! RI CITY OF PRIOR LAKE Date Reed t , ° e e HEATING /AIR CONDITIONINGIFIREPLACE PERMIT q 2,F, a— V a ° g • 4ls(P.' I. Pnk File PERMIT NO. �f'J� Gr. 2. Yellow city f (- 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS u l ZONING (office tse) c10 �I s- cakid /ec -o©& C; /V. 6.. LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER , (Name) ) NO t Sp 14 re( 4, L. (Phone) • (Address) APPLICANT 7� e 7� ro / e t /) 6 9 - _ it p (Name) , Q . NG 4 . 4 ; (Phone) 7 ' J % O (Address) CO I /. � D �)' /V t ✓ e. c 6 t/YI. f q / 5 y (Address) (City) (Zip Code) (Contact Person) kgu / / v S , Jr (Phone) 67 o 5 ) J / c1 k APPLICANT SIGNATURE �� DATE 7- `a 5 — / g , APPLICANT PLEASE COMPLETE BELOW :NEW CONSTRUCTION E REPLACEMENT ❑ ALTERATIONS S FURNACE MAKE AND MODEL et -- Y ° l / 2j4„?0 0 CO 57 FUEL /' ✓G 4. FLUE SIZE '' RETURN OPENINGS J INPUT 6 000 OUTPUT C v O 0 TYPE OF SYSTEM HEATING OR POWER PLANT [$Warm Air Plants PLEASE NOTE: Air Conditioner ❑ Steam Units and Fireplaces Cannot Encroach ['Gravity ❑ Hot Water =' Mechanical into Required Side Yard Setbacks. ❑ Radiation Fireplaces with Box Additions or DAir Conditioning ❑ Special Devices p -4eVent. System 0 Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. $ �� 6 FIREPLACE MAKE AND MODEL 6 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 § 326E3.148 HEATING PERMIT FEE $ 11 'CV "SURCI 1.1RG has been changed for one Year effective STATE SURCHARGE $ 5; 6 1.7 . 5 T July 1, 2010, until June 30, 2011. TOTAL PERMIT FEE $ 5/ 5) The minimum surcharge for a "filed fee" permit (Office Use Only) is S;, leg' tilling .July 1.2010 This Application Becomes Your Building Permit When Approved Paid �` Re >t Na. 6 72 , 4g iii Date 9 2g � (2..... p 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