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Mechanical Permit 15. 1348
- � • w ] IX — id z6v C.) k ■ « (~ < k k 25551 y o �� � � � « ad \ - o � � 0 § OO ❑ o ❑ > ■ 14 ° o \ 9 2 2 ,) 0uJ aa -I & m t Z 2 / ■ kk o IQ I « likl P § § $ 11, z_ ILL 0 0 � § rece § wict I a 8 2 ® 0 a. § 3 � § § 3 0 o Cl) o a � § ■ a � w w rt LIJ O ❑ 0000 00 % • Ce a. c 9 0 « 0 u % \ Lii 0 0 \ \ k c k 0 § 0 w q • 2 ■ © © I �k g k ��� � § rece -1„, § Q w w § m 0 0 0 Ce 3 u 0 g ei 0 B X 0.u. p ❑ c 5 U § < 0 0. 000000 U O. r"IP+ CITY OF PRIOR LAKE Date Recd HEATING/AIR CONDITIONING/FIREPLACE PERMIT `/e Z` I S U tri l �P t.rink File PERMIT NO. NNE50 3.Green City /-, I3 4/,3.Yellow Applicant `✓ / (Please type or print and sign at bottom) ADDRESS ZONING(office use) a i ligS' I 5,-t-ez\-es (IQ- Q R isz LEGAL DESCRIPTI N(office use oily) L K ','III • ' PID#36-- 930_'030,e OWNER `,,p (Name) 1 ,�cL If Y t►t:LS D ^J (Phone) P )— LI 7_'/ 77 (Address) APPLICt' (Name) A ;;, , c— 1.‘c,._ 'N\c c�--4l)� 1....1,..C._1....1,..C._1....1,..C._ (Phone) .�"T�1 $?i 1 0 (Address) / G S�7 Te 1 C g f co X C * )94 t5r"Lc kr. (Contact Person)' r c.," (Phone) 46--- - I7 'I10 APPLICANT SIGNATURE DATE /l 2 l APPLICANT PLEASE COMPLETE BELOW ❑NEW CONSTRUCTION ,EPLACEMENT ❑ALTERATIONS FURNACE MAKE AND MODEL FUEL A f7" 7.--- FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPEJOF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner Warm Air Plants ❑Steam Units and Fireplaces Cannot Encroach ❑Gravity El Hot Water into Required Side Yard Setbacks. P_WeRhanical ❑Radiation Fireplaces with Box Additions or it Conditioning ❑Special Devices Cantilevers to the Outside of Buildings ❑Vent. System El 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 $49.50 Cost$ Building Permit# HEATING PERMIT FEE $ . 0 STATE SURCHARGE $ `.00 TOTAL PERMIT FEE $ .. Mr/21 This Application Becomes Your Building Permit When Approved Paid . ("71 Z Receipt N4qc Building Official Date Date II, 2... 1 s By S z 24 hour notice for all inspections(952)447-9850 40 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372