HomeMy WebLinkAboutMechanical Permit 09.0949 o ¢~
l ,/� z 0
, \ J EW p, >`...., W
� -gc.)) c0ia z w
w_ i. 02ww � (1) • -+.+) Z Q
o U'� Q c u 8u re O: 1 W �,
1 4-)r,
♦ LU
w C� z Ana VCT 0° o 0 v4
W
n H a 0uz-. . i CT o 0 o 4"
0o a I n o
T Z ce Z- 000 .a
S Z z 0 a a x
N — 0 a minre g.5 — r7. •
N 3 z
$ , _Iwa .4 LU w w w O x rr�
a3v� a�r__. v tWi z lo
000000 kin Q °� a o s
0. G. U.0
�.
Y (n 0 p z av U.
O
UZ Ce
�-� z rare"g o CS' z ° ({ N 1- a A.
ol
0 Z (� o 0 w co '`+� F. 3 ► I w
0 AG
a.� n z fflh!
Co w W W o
0v W W W 2C:)‘ o 0 o Nct O 3 0 0 m
E3 a 0 a 000000 C.)om0 0 0 E
CITY OF PRIOR LAKE Date Rec d
HEATING/AIR CONDITIONING/FIREPLACE PEIT // / 7(gQ
NESOS1.Pink File V
2. City PERMIT NO.O Q O 4.7
3.Yellow Applicant 7
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
`1 l ) ---r) M\s t--�►-ti, S 1L.
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PIID
(Name)OWNEC\A \I C� �' J LA 41�C>��r•A %
i Y\ � '" 1- -S S
`�\ (Phone) "I-
(Address) 5 \J --11" "Nk.-).‘ S y- �. \ S L
APPLICANT \ A \ t
(Name) 'C N--% `l \\ ^.�k...._ (,1. (Phone) I S -\)N1 ' O\ d."I
(Address) V 1 Al C)(1.-4,_ iv Q 1r% U r' -\l U SS S 1
(Address) (City) (Zip Code)
(Contact Person) N .,, ,,N,, _' S Q. (Phone) q S -i LI1• 8
akdi
APPLICANT SIGNATURE DATE ( k.-- 1 1 61
APPLICANT PLEASE COMPLETE BELOW
:NEW CONSTRUCTION AREPLACEMENT ❑ALTERATIONS)
FURNACE MAKE AND MODEL 6 (..\'h,N. "SSS C two a O 3 FUEL t V C'1�
FLUE SIZE RETURN OPENINGS INPUT ?Q, a RI OUTPUT 1 S, �C)
TYPE OF SYSTEM HEATING OR POWER PLANT
['Warm Air Plants ❑Steam PLEASE NOTE: Air Conditioner
❑Gravity ❑Hot Water Units and Fireplaces Cannot Encroach
❑Mechanical ❑Radiation into Required Side Yard Setbacks.
❑Air Conditioning 0 Special Devices Fireplaces with Box Additions or
❑Vent.System 0 Other Devices Cantilevers to the Outside of Buildings
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 $49.50
Estimated Cost$ SS OC)Sl Building Permit #
HEATING PERMIT FEE $
Li CI-S1 '
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ S Q
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid so. and Receipt N°.5-9.
o 2
2-6
Date/'Y / By
Building Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372