HomeMy WebLinkAboutMechanical Permit 15. 0546 JW Z -i N
~ LL
CC
p.. W W
W
�gga? 0 44
G ! a1LLLL (�114 OMIUUlla
a7 0
0000 ❑ ❑ 2 Z
2
• V
W O
W ..._, O a a Q \ LL N
M H YYZz W Z
O 2 O O IT ...1
CO C 0
V , Z . 2= ZZ 0 V V 4
co 0 0. jzw a _ w H O ~
a �3Jw a. g z 2 1
v� a � o a Z i- a
W W 'U
❑ 0 0 0 ❑ ❑ iii"
WiI 1111 O ar = aWC
,, W
a a a0i H
iu w }
fi:
NG 0 Jre z re
50 '. c ., `r ° ate u.
aYZ M Z i= s O
OZ J O oz W F-- ▪ H :5-44,11.171,:as o c� a�� a ZF ato 0
y ? Gig • I- I—
� a w W te W OOa4 '2� W -J
aL' W
z ar r4 t y0 a q
_Z 0 0 LL {LaLZaLaA O O V V N O V
vZ < 0 a 000000 C.)
A\O
❑ c
�oi "1°4' CITY OF PRIOR LAKE C /i Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT /
INNEso�P I.Pink File PERMIT NO.
2.Green City l
3.Yellow Applicant
/6414,/'(Please type or print and sign at bottom) PP
ADDRESS
c51/87 DD a.c.� /(no //si� ZONING(office use)9 1J r`,��tJ�, AJ d id• 1 ZSl,
LEGAL DES RIPTIO (office use%y)
LOT • 011I• PIDv7jr- .35qQ,ID-O
OWNER
(Name) �m es Fi/a/-e4-) 7-27 t P,r1 (Phone) 9s z-4.90.90 S/S/a._
(Address) 091487 tear /i ,oils b i to j /42, �r^ 0 / L of G
APPLIC T J
(Name) ] I-id
it f41 jert); c es hone
(Address) 429 //An7Z�regi. / u ra �ha.�®-gyp
1- 051,� 4-e �v
(Contact Person) a /
(Phone)
APPLICANT SIGNATURE C << : — DATE ..„4--- /T
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION [ REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air PlantsPLEASE NOTE:Air Conditioner
0 Steam Units and Fireplaces Cannot Encroach
❑Gravity
❑ chanical ❑Hot Water into Required Side Yard Setbacks.
❑Radiation Fireplaces with Box Additions or
Air Conditioning 0 Special Devices
Cantilevers to the Outside of Buildings
❑Vent. System ❑Other Devices
FIREPLACE MAKE AND MODEL Require a Building Permit.
FEE SCHEDULE
Industrial,Commercial&Multi Family 1% of job cost Residential,Gas Fireplace $49.50
Residential,Heating&A/C $49.50 minimum
(New Construction) $149.50 Residential,Additions&Alterations $49.50
Residential,Heating Only(New Construction) $64.50 Residential,AC Only $49.50ri
Cost$ Building Permit#
HEATING PERMIT FEE $ yq SV
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $ S--/ws-fl
This Application Becomes Your Building Permit When Approved
MIMI Receipt Na / ���.ngMl
Building Official Date r. By
r
24 hour notice for all inspections(952)447-9850 1
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372