HomeMy WebLinkAboutMechanical Permit 14. 0851 0J
W _
_ H
~ W l�
^ * 0
Z0C1W (j 0 4
u owce5 z a
c � u Z
0
__._�r 4 ...... o ❑ ❑❑ ❑ > oe
= ,
0
W =
• uCC
0. N C
w O aaQ m clt
L F- a Q O 0 J O C II o O a
0 O w mrertamu ' a r.
v
s °' 2 0 I- g C) o o z o
U2 U2 cd
000000 4` °z °z o =
o v
a U k
W W LI
p faJ g 4, OIWz IP:hI
W re c Q qla ILI la Z 2 n: t3 V V0 O V in
�'
0Z < O a 0 ❑
N
0
o P RI0 CI i ' i II OR LAKE Date Rec'd
Pe HEATING/A ' e'I N U ITIO NG/FIREPLACE PERMIT F /5,-/V
cc f_' so
jvivEse- 1.Pink File PERMIT NO.
.Green City ------7
3.
3.Yellow Applicant f". �✓
(Please type or print and sign at bottom)
ADDRESS ç( , NING(office use)
i C G
LEGAL DESCRIPTION(office use only) _
LOTS—BLOCK Z— ADDITION,0.1/ i nem W 4 2,0A/141125-7--33 f- D/3--e>
OWNER (p �_''�'- i► `o
(Name) 1 �r( �-� Chi�/r 1 y'
(Address) ((4c( ) W ii,e rL.-.A. S 6
APPLICANT
(Name) (Phone)
Standard Heating&Air Conditioning
(Address) 130 Plymouth Avenue North
MinneapobtAibt)55411-3445 (City) (Zip Code)
612-824-2656
(Contact Person) Ii• (Phone)
APPLICANT SIGNATURE . — iii i DATE . ill ,
APPLICAN t LEASE COMPLETE BELOW
['NEW CONSTRUCTION : q' PLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL ,c,
6 (,vyi, FUELCt.( cv/
FLUE SIZE RETURN OPE S INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
Warm Air Plants 0 Steam Units and Fireplaces Cannot Encroach ,
❑Gravity 0 Hot Water into Required Side Yard Setbacks.
❑Mechanical 0 Radiation
❑Air Conditioning ❑Special Devices Fireplaces with Box Additions or
❑Vent.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&A/C(New Construction) $149.50 Residential,Additions&Alterations $49.50
Residential,Heating Only(New Construction) $64.50 Residential,AC Only $49.50
The Minnesota Statutes§326B.148
"SURCHARGE"has been extended ost$ Building Permit #
until June 30,2013,
The minimum surcharge for a HEATING PERMIT FEE $ •SZ
"fixed fee"permit is$5.00 STATE SURCHARGE $ S-
FOTAL PERMIT FEE $
(Office Use Only) +
i
This Application Becomes Your Building Permit When Approved (r v Receipt No. ) ► r r,
ki SI
Building Official Date , �� By
/ •
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 AO
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
r
II
II
r