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Mechanical Permit 13. 1205
I O O a 0© ■ ' 0 /2222 11 X 0 K0 n °° 2 . JE 0 8 G rn 2 2 q hi As r m ® ^ • �— rn � / � � k 2 § -1 tti t� �q �� �' • 2 $ § • P B � 10 -4 ■ g , -4 m o . z - q � > . no. U §2 $ 0 q ill I Vi i■ z k k % r I % , ! m m X § 'V � / �- • f �} / f ���� � ` 000000 m i . o -1 z o § • � - � ' � o ) c 2 »m 7 2 c? m ' � � m x n ■ % 0 k k >0 m 0 m m d o z i r33 Oo ■ rf �� s \ P � � � & , �k� o b ■ - o m k c li \ L OO'ODO R. » z Xmm o § § '09 _ )1.< � j k �mm IMP AP - n ■ r - • �t § m •-■ 0 A A • A . • 5 Q /n'� r . C7 00000 0 = 0 > r Zc7 n n a o o 0 0 H�z ��� 0 O n 4 Q r>- n X m x I _ m >cAZO 2 el m n A N m z > zo z z c �-0 1 z O o O z xi Ri o 7 Z 1 O D z hi 0 r > 2 ' mm m o 73 77 Z O O m x m III m '` 000000 o ...1 y G 0 k Mr- r "� m C 4 c = . m x . _u o y m , - I zz 7J 0 ` x tt 1 0 z P' r ?iO O o 3 m Po o y O = , --1 rmm O m A x G x m El 0 0 y m ❑0 ❑11t00 Z z R. > z O:azin t > m �5�o . (� z 1 rI 4 m > mm=q xT73 -I r d c c n f z m ..,1 r 0 , C2 .../ 4 ( CITY OF PRIOR LAKE Date Rec'd HEATING /AIR CONDITIONING /FIREPLACE PERMIT 4 iiMvEso: 2 ct«n Fct PERMIT NO. ff 1 5 3 Yellow Applicant 1 I (Please type or print and sign at bottom) ADDRESS ZONING (ace use) L 120 V k !k • - LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID O WNER (Name) �ta say. ),-S (Phone) (Address) APPLICANT rr 2 - I 4 1 ' 21e (Name) 1 t 1n C. l '� 11('4. C. (Phone) (Address) t2 it CA..G( ( _ok. C ,{ rG I.4, Ed(.. v'a M, N GS 4 "A (Address) (City) 1 (Zip Code) (Contact Person) Ma 'VCZ 4.- (Phone) ' APPLICANT SIGNATURE r , a. i , A' 4 ... 1 a.lii I ATE 1 O I E S I l 3 APPLICANT PLE COMPLETE BELOW ❑NEW CONSTRUCTION Di REPLACEMENT ❑ ALTERATIONS FURNACE MAKE AND MODEL 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 Fireplaces with Box Additions or DAir Conditioning Special Devices 0 ❑Vent. System Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE A N D MODEL 1\A D v r t - p a t - ( X W O l d a 1 t,l S e * FEE SCHEDULE Industrial, Commercial & Multi Family 1% of job cost Residential, Gas Fireplace $49.50 $49.50 minimum Residential, Heating & A/C (New Construction) $14930 Residential, Additions & Alterations $49.50 Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50 r_.: —_•_' Cost $ Building Permit # The Minnesota Statutes § 326B.148 "SURCHARGE" has been changed for one HEATING PERMIT FEE $ year effective STATE SURCHARGE $ .50 July 1, 2010, until June 30, 2011. TOTAL PERMIT FEE $ The minimum surcharge for a "fixed fee" permit l ' is SS beginning July 1, 2010 This Application Becomes Your Building Permit When Approved Paid 79 ? r - R No. j/ Patc Building Official Date i0 a 1 7 B • 24 hour notice for all inspections (952) 447-9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 • its . .4)