HomeMy WebLinkAboutMechanical Permit #12-1453 N o o .� c� aooaa❑ = o o y�
O u,,,Z��+�+ o � v ��
n c� S�3 ��� 3 r�i �c� m � m n�
o G a o ��� 3 Zr �oZ Z vi ��
ta F c "' i c "' i �, z � 5 � -si � •° ° �
ro � D u N� z o�
� �° � " - (� =' �
� T A D O = IC, m m
D = � � I
� � r � � � �
_ „ � �
� m °� o o OOO❑O❑
'� x m m m m�
c c
o� Z� � v o =���_� m A A
� �e
� � � � yc 3 Z m
m � �' ri�00 � .� � v
� o Z �� C
�° z � m � ��� � o
h A O
= m
x O � .�
c
N m ❑❑❑OO❑ N
� � c) r`' � i
� = Z ����Z` ` m
R` p � rv�1-vr� � �—
� Z � D�DD� � �
Q'1 A �� � �
mm
y m �o ,+ �
�c' yz = m
-i � �
O 4 PRIp�� CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
� � � � �`��� ��
�I�'NESO�� 1. Pi�ilc File
2. Green City PERMIT NO .�� � f �
3. Yellow Applicant �
Please e or ' t and si at bottom
ADDRESS / `, ZONING (ott use)
l 1 � �� I�G� �� �C- i L �C /� �
LEGAL DESCRIPTION (ofl6ce use only)
LOT BLOCK ADDITION PID
ow�v�R �''� � �l� �1�.�
(Name) (Phone) ,
(Address) �t L (� �
APPLICAN /,_ � �/ —
(Name) ' V (Phone) '— _
(Address) � . � � - � �/ � � /�
(Address) (City) (Zip Co _ /
�� � ` �¢
(Contact Person) one)
APPLICANT SIGNATURE DATE
APPLICANT PL COMPLETE BELOW
❑NEW CON RUCTION PLACEMENT ❑ ALTERATIONS �
FURNACE MAKE AND ODEL � FUEL /�
FLUE SIZE «�� t RETURN OPENINGS INPUT � OUTPUT C�
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.
� echanical ❑ Radiation
Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
❑Vent. 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 minimuxn
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
i ne ivimnesota �tatutes g s�bts. i4a � Building Permit #
"SURCHARGE" has been changed for one
year effective ?ATING PERMIT FEE $ �9• .�
July 1, 2010, until June 30, 2011.
Tl�e minimum surcharge for a"fixed fee" permit �TE SURCHARGE $ .S Q.�
is �5, beginning Juty 1 , 2010 TAL PERMIT FEE $ �`'�
-_ n._ nncn i ..
This Application Becomes Your Building Permit When Approved Paid L,/�� Receipt No. �� �/�
�� 7 d
Date / ., /,� /,� By J y/
Building Official Date ���y� ��Y"�-�
24 hour notice for all inspections (952) 447-9850, faz (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372