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Mechanical Permit 13. 0987
: }] 4. 2 \ - } § ` # - W :6' § Sq 1 j k m . � < ƒ ) 72§ \ 1 > o ■ UJ un o ° iii § E °77� ~ `1 2 ? § Ocoe ® » > m 1 Z / . ) - @ 0 \ §§ 1 N 0 • c2 / 2 §§ I ~ . \ \ 0 Si / Z k k�}}§� ` W "' \ \ a / z Q O. § §< 1 /S 2 1- lb ■ m Ll. ■ ;) ■ q § ( X § OOOO � \ % 88 t %% j, .. , 7 %I" W \ < § \ W '141‘, ° U 0 k . u_ \ c / 4...,_ 6 2 S 0 S '` 2 p / 0 2 o < e e m �R 2 i =Z -J 3 i© §§ § } 2 c uj W / R0Ce2ƒ/- 2 ~ b § § $ § b R ���? D • .. o 0 a 6 z < 0 a 0 OO=OO U 0 0 f Q - O � rRlp CITY OF PRIOR LAKE Date Rec'd : _ '-' .. 7 HEATING /AIR CONDITIONING/FIREPLACE PERMIT ` . ` - .' 1. Pink File PET NO �INNESO 2. Green City i7 — % 6i 3. Yellow Applicant C,/ (Please type or print and sign at bottom) ADDRESS , 1 ZONING (office use) ` i 1-2,t ve LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER r � 2/1 ame) \ )Cd� : 1 i'10 ` a r ( !. ;y) , ,l ` ' -{ __+ k i dn) l / 1 2 -t - • (Address) )�'1: i•t,�� Ali . ' I -`, _ �.:. �__...._a A_t -� ��F _ _ �:� �:_:__ .. .'� APPLICANT f) 'i �`') ( ( [ + /1-ermsL_____ ' T u-C ame) E ') ! i3O i ; 1 C 4 1 •� �: - {- �., ,. Phone ) (.i f I J ( r' l 1 �/� 1/j i f } J (Address) 1 ( ( -..) C ( 1. '� C f i / )// 1 .-- ii 1"!(-l/( 1 � ; A 1 3.l _� " s� (Contact Person) : t. r ` m - ` r � � ' _. ' ( `' i �- �(� . x ! d PPLICANT SIGNATURE i DAT // � / APPLICANT PLEASE COMPLETE BELOW ❑NEW CONSTRUCTION El REPLACEMENT DALTERATIONS 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 0 Steam Units and Fireplaces Cannot Encroach i0 ❑ ity ❑Hot Water into Required Side Yard Setbacks. ) echanical ❑ Radiation Fireplaces with. Box Additions or ❑ Air Conditionin i ' f b ❑Vent. System Other Devi s _. Require a Building Permit. FIREPLACE MAKE AND MODEL /4'(j f if f l: _ S E SCHEDULE r �� - ��•� Industrial, Commercial & Multi Family 1% of job cost ` ' entia, l 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# HEATING PERMIT FEE $ r9` S STATE SURCHARGE $ 5.00 • • TOTAL PERMIT FEE $ ,', ' ' cJ -) This Applicati i ' 1 I . . es Your Building Permit When Approved Paid 5q Rece' t No. 7 00 / Date 9I Buildin Official Date 7.4 hoer notice for all inspections (952) 447 -9850 B