HomeMy WebLinkAboutMechanical Permit 10. 0114 5 ❑ ❑� 0 00000 0 'fl 0 > ZO
v 0 n 0 cn ?Iz m mm p p .
0
Vl (n
n o 73 7J 7 3 m c m m b z Z � N � - m O ) 0 z • co -alb .t "Ti 0
o
'1 0 ,? n o o m�
-L m
z 0 r z al
x '
r o
x m 'D V ir
• rn o 7J 7J
x m m m mrN�mr ��
A - z o o C)c ,
C, x3 mx 13 0 cn
y •c z v -n 1 : 1 2 m o o
zi C m o o > 0 3 -1 / m
't n 0 p r - nOO 73 -1 73 C
'i
hi _ - o z Z 7 7 z ) r
O z ' m r - 1 v -0 O , O (
• A 0
x m 1
O n p in' PI 53 ° m
• C
m
f--
0 ` 0❑❑ \ 00 m co Z ( 0T �nnm �i' ° ,......,
• D m�sr>
' z 7 0 0
m 55 -n73 -1
t m=- z m
-+ r 0
( rviti---6 -a_4' CITY OF PRIOR LAKE 0 OO / At Date Rec'd
if b p ° e HEATING /AIR CONDITIONING /FIREPLACE PERMIT
4t 1. P ink File
2. Green City y )
NESO PERMIT NO /`- O //4_,,
3. Yellow Applicant l./
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
./69S , /; n d T A
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER Q
(Name) CS Q& (1 n 9( �,t�,, 7! /_
l JI.YI `fl .�C ) C \ (Phone) 9j " 1 ! 1 UI /
(Address) /Ca( ii)) n <A 411; l 1 ?c 64_ 3 0
APPLICANT _ 11 n�
(Name) � ceC\ 5 NO'( \- \ �� d �UG \ (ihone) 9) C? 6- 6 n r ( 7
(Address) J ( 0 O►` 1 �, -i v. I JCT 6 ]T ah1 5 k& , Mr 1 6.4 -3/(c
(Ad• ess) (City) (Zip Code)
(Contact Person) , Ad a _ (Phone) 3 "3 - /0
APPLICANT SIGNATURE A%/ DATE
r i P L IC A N T PLEASE COMPLETE BELOW
LINE ONSTRUCTION - [ REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL ` Gt I e 7 (�-q /' At- \ 36 O 4 0 FUEL I'M
FLUE SIZE ? V C- a -\\ RETURN OPENINGS INPUT 0 0 000 OUTPUT WeD
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.
[SJvlechanical E Radiation Fireplaces with Box Additions or
EAir Conditioning ❑ Special Devices
EVent. System E] 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
Estimated Cost $ /99 9 Building Permit #
,--Q
HEATING PERMIT FEE $ 4/9 6 `-
STATE SURCHARGE $ a 50
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid,... . eipt No.59
Date ,f ji b y
Buildine Official Date / v
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372