HomeMy WebLinkAboutMechanical Permit 15. 1189 000
\t.-
n oo 0 2n .-- I g § § n
k 1- o k k x 3 _ §cEZ § $ 73 0 0�
2 m cn EB§ 0 P ox,
Q
co z § > . m z 0_
S 7 O 0 0 7-1
% / a m m
§ r § 7
o 'to z
X =
% m
Z
■ §fil0 000000
41 0 z00 mritmr I
% / ƒ § �1voi OC -IOC
m 0 b Cn
■ m zzzz z ■ z =
q 2 0 0 r $ §§ % § p ., 0
Po
0 g co' m ,- k-0 Z m
r. 0 . I r o
■
m\ 0 �k \
C.--)
y ® $ O DOQ (
z
R. > 0 71202 §
■ mm ■ o 1—r]
i c � � �ri �
41 z
m � mmIl
■ -n ■ r -I
c � z m
-1r o
01 PRI
o„c CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
j�'NESO�
1. PGreen City /ink File PERMIT NO. /57 ,I/Q 79
2.
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS3 ,5 ZONING(office use)
(b
\AM e otc, \rn
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID / DSS — 0
OWNER (2-
I �+(Name) (j a i d Ft Ch (Phone) 1- 1
(Address) '\ M , I 0 JO 1� a 1/ \ To n
APPNamLICe t patr-. +f/„ /�
Y I - ��`i',� �
(Phone) / J), q / 1 /
(Address) (O E O V t O,0 On
D I
(Add ss) ( )
(Contact Person) ,11„ , Si 0 kA.J( (Phone) 1/ '' , 4%014
APPLICANT SIGNATUR= £ mS ./ DATE ' / -
APPLICANT PLEASE COMPLETE BELOW
:NEW CONSTRUCTION in REPLACEMENT 0 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
❑Gravity Units and Fireplaces Cannot Encroach
❑Hot Water
into Required Side Yard Setbacks.
ID Mechanical ❑Radiation
❑Air Conditioning 0 Special Devices Fireplaces with Box Additions or
❑Vent.System ❑Other Devices Cantilevers to the Outside of Buildings
OwFIREPLACE MAKE AND MODEL
l.�Io Require a Building Permit.
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 $49.50
Estimated Cost$ Building Permit #
HEATING PERMIT FEE $ HCI F.2°
STATE SURCHARGE $ 1.00
TOTAL PERMIT FEE $ P2Q,L70
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid ✓o Receipt No, 0 5
Date .)� Ic By 3
Building Official Date J
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372