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Mechanical Permit 14. 0443
J1-- -; a' icIr Ole kl 1 UJ cc 0 IMO Wz > > a N O O 2YY � X fin► II _z- = = z ? v d a t z v a m = WLu a� m = ' a 6 2; ZDO DO /-1D0 O W W )- i, a23na2 UJ ❑ ❑ ❑ 000 o UJ LU w o u; (�(� _ W W " O < V u 04 Q F- Z JO •�krol LL a' Mi ti IO = . . O = W IC_' N < '. cOWyl Ft O c7 <C7�• O• N Z < a- AC a� co z 30E5 _13 W co W W • I W u.or- co W a- Z � � W a a' 0 ' Q O a O OW Ce erre = O N N a 3 o u.LL u_= tLN 0 V V IL in C) = Q O a 000000 0 '9, ❑ 0 c 0 1 PRI04) CITY OF PRIOR LAKE L--- Date Rec'd ti HEATING/AIR CONDITIONING/FIREPLACE PERMIT 5 t 30. i d U ttr! 1.Pink File PERMIT NO. /it• / J`�►'3 �INNESo�P 2.Green City I J 3.Yellow Applicant f�► (Please type or print and sign at bottom) ADDRESS ZONING (office use) 15?10 ( d5 7( NW t LEGAL DESCRIPTION(office use only) 51, LOT 'i BLOCK Z ADDITION 4.4 u',4 5.----142�( PID q§"• 3 f5` D Q.-e• OW(Name) 1scc'iI PQIov' ( )"ISL 055 CJS , (Address) ego Wilds iJ( 'Wt?/ UV FroU1t ? g5 --71.. (Name) ANT V 'S GV 1. �l C ) ( (Name) K P ' Phone 14115 2& ) 6R (0 Dr9'fltcOPfe `-- Q/ (Address) l ...____ (Contact Person)400 0 / (Phone `C`-C) (: t7 APPLICANT SIGNATURE .+ I 0 DATE Fj--a--' Iti .... APPLICANT PLEASE COMPLETE BELOW DNEW CONSTRUCTION ErftEPLACEMENT ❑ALTERATIONS 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 ❑Gravity ❑Hot Water into Required Side Yard Setbacks. ❑Mechanical ❑Radiation Fireplaces with Box Additions or L'Air Conditioning 0 Special Devices Cantilevers to the Outside of Buildings ❑Vent. System 0 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 $49.50 Cost$ BuildingAAPermit# HEATING PERMIT FEE $ • ) STATE SURCHARGE _$ 000 TOTAL PERMIT FEE $ bit-.InU .I This Application Becomes Your Building Permit When Approved ,�� iliaga Receipt No. 1 ' I+ Date © ra By Building Official Date _ _ 24 hour notice for all inspections(952)447-9850 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372