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Mechanical Permit 14. 0373
2 � � § § , � CC- -u * \ \\ I k \ * aaa � 0 2 o ■ ww � ■ . � 5 o ■ ■ « z 000000 `� w 2 I. u o _ , u. 0 0 a s m L 0 2 § § J § � z 0 b § § a § « 411 rz P. 0 0 UJ § ■ ceceEd � ' w \ k 0 & Cl) Q §§ I- § §3 a. 2 2 X § mow « _.4 Ili w UI a ■ ■ tea 0 0 z O ❑ cOO ' , § Q. § k / o z Lu 0 z a k © . . z < 0 � § 0 z 0 z 0 1- k / 01 i W zE2 a r0r. a• 2 < © UW 111 % 0w § ZW § 33241 ait k k k � 0 0 0 § U. U.3Ik 0 i ix 00 4,...0___ 0 g E52 2 0 a 000000 C.) 0 0 oi rizroie CITY OF PRIOR LAKE Date Rec'd 3 . HEATING/AIR CONDITIONING/FIREPLACE PERMIT 1.Pink File PERMIT NO. 2 h1/NntEsotl. 2.Green City i`� .-3 13 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS l ZONING(office use) 5-555- Lest No r"; zo,..1 Cir-ck S _ C— . LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) j- . ( E v A , s (Phone) to') Z — (- )$ - 5-W S/ (Address) S'fo / I 7; )ci-okketTfece Gil.,-. ICP.-e9 Seo In o ,e k Li a, 7 k-4:94 APPLICANT (Name) 0 ; M ANA txl QS P15 1 (Phone) So 7 - 3-'3 - 1,1 b ) (Address) lay 1,0 . C ,-k s+ p i i7 n r-I- L to, 1 YY)!J 5‘,o c,7 (Contact Person) pl i kg_ („j 4,,.5 c,.,,,,(Phone) 56 - 3 7�'3 - (/L 1 )) APPLICANT SIGNATUR Cn/o.—� DATE ,/ /-2 o APPLICANT PLEASE COMPLETE BELOW ❑NEW CONSTRUCTION RREPLACEMENT ❑ALTERATIONS FURNACE MAKE AND MODEL fl i'i j4 Ai A. FUEL N.,tt„w.1 Gas FLUE SIZE ' " RETURN OPENINGS i y k Zo INPUT a 5,. c v OUTPUT C, , o V a 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 NAir Conditioning ❑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 $49.50 Cost$ y c). cc' Building Permit# HEATING PERMIT FEE $ 9c} .co STATE SURCHARGE $ 5.00 TOTAL PERMIT FEE $ 5Y 1'J This Application Becomes Your Building Permit When Approved Paid 541 3zi Receipt No. 7421 7 l /� Building Official Date Date . ///)//4 /h//4 By? -1,—/-..---> 24 hour notice for all inspections(952)447-9850