HomeMy WebLinkAboutMechanical Permit 15. 1143 ƒ O 0
2 000000 0 > En
k a 0 xi 73 c 00 m22n08 z m § �4
r k» cc § m m m mo
r 10 t / cn Z k3kkk P co cs) 57
\ 2 ] l n 2 z 0 k
F g q 0 z ■
i 0 z2 mm
r o 3
X $
'11 J o
km zm 000000
- C', � � � � ■ �
$ 2 % § I films
- n ■
m % § zz77�§ z x
/ S � �§\ § w 2
\ k0 / m
r o
0 . � ! m
\ / §
g m -
2 z 900000
%
Q 11 o"311n2 _ � g
\
�'0 ' ® -
g
§ P 7 afcgi
357"3 -1
§
§ §
�� PRj0
ti� CITY OF PRIOR LAKE
Date Rec'd
( HEATING/AIR CONDITIONING/FIREPLACE PERMIT
�'NE50�� 9'` , f
21.PinkGreen File
! PERMIT NO. ki // �3I
.
Please t 3. Yellow Applicant
( ype or print and sign at bottom)
ADDRESS ZONING(office use)
q35 6?/ 'a te. ,odace_ S. . PrySZ)
LEGAL DESCRIPTION(office use only)
LOT 9 BLOCK Z ADDITION C .trirrej, �( eetza, 3 7 PID 4..7 5'3/6 o z Y-0
OWNER �—^ 6.€2/,----
�
(Name) 3/ O e_ t;�'2 2 i Q
/ (Phone) % S L- LL/ - 4,.33 b
(Address) 5S"73_1" Cy b/� ,lcf caS E, /e, c< (c A /0'l../
APPLICANT
4.2, z
(Name) !/ 4jj (Phone)P _4.;c . 9 z -7�6- s :1
(Address) 7225j N/CA//-ei"" • d., ` . !
(Address) St/•�CQ2f 4.1 515—.1-i 7
(City) (Zip Code)
(Contact Person) /
Ce-4---e--
(Phone) 9 3'Z— 7 YG- S Z,4.�
APPLICANT SIGNATURE 4 ` — DATE 9/ ,f—
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION XrREPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL .t0c;O�G„ &'.-31-7,cc96 Og03 �,v FUEL 17 a/•
FLUE SIZE RETURN OPENINGS INPUT YO O co OUTPUT -76 (30 4__
TYPE OF SYSTEM HEATING OR POWER PLANT
['Warm Air Plants PLEASE NOTE: Air Conditioner
❑Steam
Units and Fireplaces Cannot Encroach
❑Gravity 0 Hot Water
into Required Side Yard Setbacks.
❑Mechanical ❑Radiation
❑Air Conditioning o Special Devices Fireplaces with Box Additions or
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
Residential,Heating Only(New Construction) $64.50 $49.50
Residential,AC Only $49.50
Estimated Cost$ '4.6/ / Building Permit #
HEATING PERMIT FEE $ (/ ?. -5-19
STATE SURCHARGE $ 1.00
TOTAL PERMIT FEE $ Tti-
(Office Use Only)
This Application Becomes Your Building Permit When Approved P. : P LI
,ra Receipt No. �/���///����
3
Date ` By
Building Official Date l . Z) , LJ
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372