HomeMy WebLinkAboutMechanical Permit #12-0786 y O❑� C� 00❑O�❑ = O 0 N�?
n A � o 0 0 � a, �N�cg m � � m�
b r ° m m 7�C m Z�SZpZ Z � y ��
t� � � -� � - m ���� O Z �
.� D
p � D y N n Z Z Z �
� a '� � p � �
° ' z - � Z m m
� O D Z �
� r ° � (1
� "' °� � � o00000
'� m m m m m�
>m
�� y o v � �;��_; m O A
� �' � � ��xs�� 3 m
� �
� p n p r?��� � � g
� � o z �
�° z q m ��� � o
� � �
o m A
� � � n
y < ❑aoa❑ �
� Z Z �.�� N (� �
�. o � ����� � �
� Z (m�n�� � �
�� �
� m a"� � �
� y � �
o � pRj CITY OF PRIOR LAKE Date Rec'd
� 9 HEATING/AIR CONDITIONING/FIREPLACE PERMIT
� �
U t�
�j�'NES��P t. Pink File
2. G,.ee„ �, PERMIT NO. � 2- 7�6
3. Yellow Applicant
lease e or ' t and si at bottom
ADDRESS ZONING (ofleice use)
� 2. -� S�- S�
LEGAL DESCRIPTION (oflFice use only)
LOT BLOCK ADDITION PID
owivER C ��1 l ,lS����'�
(Name) �^ (Phone) �.�� � — C�UU J`J
(Address) ��� s� SC-
� PLIj ANT ( ) ��� `�,.� � �
ame �����z Phone � c` i
�
(Address) 3�51 W. Burnsville Parkway
"" ess) (City) (Zip Code)
����h���i�lP. N 55337
(Contact Person) (Phone)
APPLICANT SIGNATURE DATE — I�
APPLICANT PLEASE COMPLETE BELOW
�� ❑NEW CONSTRUCTION REPLACEMENT ❑ ALTERATIONS
��CE MAKE AND MODEL �jjti,�[�.�� 1�3��1�� F�.
FLUE SIZE RETURN OPENINGS �I' � 1 �77 1 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
� ir Conditioning ❑ Special Devices Fireplaces with Boz Additions or
Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL � d
FEESCHEDULE
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
Cost $ Building Permit #
The Minnesota Statutes § 326B.148
"SURCHARGE" has been extended HEATING PERMIT FEE $�� r��
until June 30, 2013, STATE SURCHARGE $ S(�70
The minimum surcharge for a TOTAL PERMIT FEE $� � 5�
"fixed fee" permit is $5.00
_ __
This Application Becomes Your Building Permit When Approved Paid�� /�p Receipt No. `!�/�
`y` �� l� Qv b
Date / L By
Buildine Ofticial Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372