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HomeMy WebLinkAboutMechanical Permit 11. 0866 10 0c n 000000 11 0 > ■ o 0 ■ 12 � -'n 0 & 0 2q 00 X28 m m mo • I- .x al xi c 7-1 -1)r. 0f 2 $ §o� Q P �0 2 » :.I e -4 m z @ 0 ■ C ■ It 0a If § . n� AP hi ■ § q , mm n • z 73 % -I • \ mil �. . m 2 0 0 , OOOCOO z m m g .00 * ® � hs z ? m43 x II � ` \�§ X1 \k � 0 0 2 m - N. > 088 § IP o ■ FFil z ' § r -0-a z m z # m C • = x 0 § \ ❑� DX oO P ■ Z @> 22 §§ �m » r � -0m >0 Q � © \ 0� Mm4 , M § q _ rSC . ■ -1i 0 04 r RIo�04:70F OR LAKE Date Rec'd 9 HEATING/AIR CONDITIO G/FIREPLACE PERMIT x Q r� jNNESD�P 1.Pink File 2.Green City PERMIT NO. 1 I —U 4 p 6k, 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) 3q(0 Wood d )ck )C- LEGAL DESCRIPTION(office use only) • LOT BLOCK ADDITION PIP OWNER ( _ (Name) IlIG-4 )C.� 0 SLK' d ff (Phone) 6O(2."�`I 5 67 v (Address) S4 tM e (Name)APPLI 'I c (�� e LtC (Phone) �'f 'o2 SoZ-o'ib$y `�w/i.► 411'.ft1 � 4c (Address) B' I 6 W 4Cs4 L1., 41c S 1-1"r,L C C l d M l`J cS z 3 ( pp (Address) (City) (Zip Code) (Contact Person) J ll1, rt S ecL e( (Phone) 1(2 62 Rd -d-68(1 APPLICANT SIGNATURE l -i*k— DATE /—f—If APPLICANT PLEASE COMPLETE BELOW ❑NEW CONSTRUCTION A REPLACEMENT ❑ALTERATIONS FURNACE MAKE AND MODEL G�i /FUEL rr. FLUE SIZE 7 RETURN OPENINGS 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 0 Special Devices Fireplaces with Box Additions or OVent.System 0 Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL e-c N7.4'i' 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 $49.50 The Minnesota Statutes§326B.148 lost$ Building Permit # "SURCHARGE"has been extended until June 30,2013, HEATING PERMIT FEE $ The minimum surcharge for a STATE SURCHARGE $ .5'. "fixed fee"permit is$5.00 FOTAL PERMIT FEE $ This Application Becomes Your Building Permit When Approved Paid f 4 zek lox Receipt No. (031 y Li Mem" &IP 1 i— i ) Date ' �� By Buildinc Official Date 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372