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Mechanical Permit 13. 1282
_ 2 0 0A( nn 0 000000 '0 0 > n 2 n a 00 0 0 ■m -mm, 6$ o K q % m k a kKk m m m 2 % t -I - m Z 0 � ��§ k �� / � % o§ k Z m 0 ® -® P 2- © �` » z � 73 % - - z gp z � \ § k k n �� �� k m \ 0 0 • )400000 k � i ■� ■� • �� amr 2 k z 0 - x m i& n '�' co c m m IMP' �_■■_xi W m 0 0 2 / Z I §§ 3 . m , /2ko 0 71 2 � Z c / 0 . §§ Z m ` 0 N m $ z @ 0 0000 0 R. » § o'n 'n n ! ? \ ��k kil 1.,34, n m ;; m ) ,- x m m � r - k/ B m .PRIp CITY OF PRIOR LAKE Date Rec'd ° � HEATING /AIR CONDITIONING/FIREPLACE PERMIT /f `/ i3 ti 7 U V 1. Pink File PERMIT NO . /3 / Z t L I '�INNESO�P 2. Green City � 3. Yellow Applicant (Please type or print and sign at bottom) ADDRES l ZONING (office use) tere � )75 a--- l Cp�� 7 / ✓e- tia,,,,,/its Akie_ 5 LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) / (Name) CAN � / 1`a� ( � C C1.9-e0 tk..-- ( Phone) ./Z 36 °( 79 76 (Name) l d– °� `� (Address) ? exyx, / Y i _ � 1-1- � °t. L sd- iv".J (Contact Person) ) (Phone) APPLICANT SIGNATURE - DATE // 1`7 -1 -. 1 APPLICANT PLEASE COMPLETE BELOW ❑NEW CONSTRUCTION REP AEM ['ALTERATIONS E _ /�� FURNACE MAKE AND MODEL Dp y✓l g A FLUE SIZE „\ ---le RETURN (7PENINGS INPUT .S B coo OUTPUTS TYPE F 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. 0 Mechanical 0 Radiation Fireplaces with Box Additions or ❑ Air Conditioning 0 Special Devices Cantilevers to the Outside of Buildings ❑ Vent. System ❑ Other Devices 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 Cost $ Building Permit# 4- r HEATING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ P L This Application Becomes Your Building Permit When Approved Paid 51) ReciftNo.7a4(/ Date/6 f, d B Building Official Date i 24 hour notice for all inspections (952) 447 -9850 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 _ -