HomeMy WebLinkAboutMechanical Permit 14. 1029 OJ
0 k4
�O4a�//��acaa �ccg
,t
01
^ 1 V W W N ill
0 FI
V O
i alO
N
p
u. -.
cu \ O am o0
a
0 Zo VW
W 8El: -.1 O 042 L
wZSO <2 — + zL V d O
V Vd w w
N
? aia.
VW ti �
J W < J W W
a23wa2 WW W0.
WEI
00000 cj V O ce Z
\ aaLL wH
rt
FN''''-......... Q <
O IQ
V 1-
YO o
to
ZOOO N a cp
o
E Z a z
O ~
N Zmw
w
W ei Za 3UVO O
< a y
5 : O ❑ 000V 0 0 c
t.
1
1
a
o'-. rxzo�r CITY OF PRIOR LAKE Date Rec'ld
�,(2V w.s HEATING/AIR CONDITIONING/FIREPLACE PERMIT Z./`t--
>
/ I.fink Fite PERMIT NO.
j 41iJyp oSp 2.Green City
3.Yellow Applicant r �O s�
(Please type or print and sign at bottom)
. ADDRESS ZONING(office use)
t 51 in f.-10-\ -f- . Pc1 . Tri DI- 11-.
LEGAL DESCRIPTION(office use only).
LOT BLOCK ADDITION PID
+[)WNER as 9 a
(Name) sip, �.-0 1 a % i v (Phone(S2) % 2 (p?ji
(Address) r.5 l ID a is Pt cL -. !x'tc
,
A PPLICAN ® e� rl i
(Name) l t�tn cGv - �('�. LU > (Phone( g 1.Z)? 5E Si 9,..3 j
(Address) 'AO . gr. _
(Contact Person) VA( (Phone)
APPLICANT SIGNATUREe„...------- DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION REPLA EMEN 04 LTERATIONS
FURNACE MAKE AND MODEL 0- ym WID 5-16-1,LEXTUEL
FLUE SIZE RETURN OPENINGS INPUT-12,,6D OUTPUT i]ilia
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
❑Warm Air Plants ❑Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑Hat Water into Required Side Yard Setbacks.
❑Mechanical 0 Radiation Fireplaces with Box Additions or
El Air Conditioning OSpecial Devices Cantilevers to the Outside of Buildings
0 Vent.System ■Other DevicesRequire a Building Permit.
FIREPLACE MAKE AND MODE ' IL ...2 Il` a,, I114' . '.,yam
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!!
HEATING PERMIT FEE $ 4'q/9)
STATE SURCHARGE $ $ ,Ti '
TOTAL PERMIT FEE $ S
This Application Becomes Your Building Permit When Approved Paid Rece o. 7irF
z •
Building Official Date Date 9 L 3 By
I
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
t