HomeMy WebLinkAboutMechanical Permit 09.0925 5 00 0 0 000000 "a 0 » § 0
O o) — n11'l 0 § 0 � 4
n 0 k x' a 3 C3 C mgc; E9 m in m omo
§ r R k § 0 M E -*-o z A 0 q-0
hi r 0 n ■ 2 $ gogQ 0m
tIQ . § 2 o z 2 .
L § 11
3 > 0 . d
0 z 0 m m
/ 2 r k 15:f'fts
ig x r o
® 0 00 D 000000 }
§ UN
§ § § § mucn a te
®m
E ® § 0 X§ mis n CO
■ C ? M . 71� ■ ■ Z : in 0 0
R m G \ z > 000 0 § q ik m
~ § o r -no0 2 p E
d / z z x 7 z r
0 2 § � \$ P o
/ _ x
« n , � -
% 2 . � ' �' OOOO ❑O
2 < � . Q 'mn§ 4 ;
zz _ 2273 0 �,
RI Z; ' CO22 � ® I m
\ 0 Ch. m\k§�
§ cn> z- m
"4r o
Y RIpCITY OF PRIOR LAKE Date Rec'd
'Iva HEATING/AIR CONDITIONING/FIREPLACE PERMIT
INIVEso 1.Pink File
2.Green City PERMIT NO.Q 962,5,..
(Please type or print and sign at bottom) 3.Yellow A licant 7
ADDRESS ZO1 TG(office use)
15-7Iq - 7.5i-) -R ; rffr -fri 5E
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER C1W) 4(Name) 1 C_/hj r aoh 11 SCY� ( n 1 7 -4 531-1-
(Address) I S'j I 0) j `51-) -P3 I f'f 7d 5E
APPLICANT
(Name tit AI 1% '.oft. 1. ■ ' `a '
. (Phone) 4
- 7CTQ9
(Address)_ c 1,p -. lC . 1o
U I D=t_l
(Address) 9 (City)
(Zip Code)
(Contact Person) CT .I ) J (Phone) 9' i—y-?i — 7�q
APPLICANT SIGNATURE--Q CI D i I-c
ATE ✓V` 4
APPLICANT PLEASE COMPLETE BELOW
[NEW CONSTRUCTION RaPLACEMENT 0 ALTERATION
FURNACE MAKE AND MODEL — U€s P\- 1C) FUEL a3-111-1X01-
FLUE SIZE (O11 RETURN OPENINGS INPUT karrf) OUTPUT 01:::
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air PlantsPLEASE NOTE: Mr Conditioner
❑Gravity 0Steam
0 Hot Water Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
®'1Olechanical 0 Radiation
�filrr Conditioning 0 Special Devices Fireplaces with Box Additions or
[Went.System 0 Other Devices Cantilevers to the Outside of Buildings
(' �1' � Require a Building Permit.
cIRi�PLALE MAKE AND MODEL 'r� ( .- U O3� _ �'1-l-or-
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 $49.50
Estimated Cost$ 7 get c12' Building Permit #
HEATING PERMIT FEE $ Li-q•3
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ C(5C�
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 5-77troRec 1No.
no
DateBy
Building Official Date 11. 10.V .
24 hour notice for all inspections(952)447-9850,fax(952)447-4 45 4
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372