HomeMy WebLinkAboutMechanical Permit 16. 0099 E 00 n 000000 1 o > & 0
0 0 ■ 0 § g§� oo 0 m 73 om /
k \ k k k m in■r� 'Ekz 0 Ca ��
hi r n n ■ Z $ � o� Q 0 Z —
'1111.*to o 0 u• m /
e to k Oo z Mm
N o / z 3 7 [�
11 2 "0 lb
% m 2 0 § . a 000000
E 11
41 x - m m _�� � � cn ImE
* § ■ § mI § m p n
K ? m ZX77 � z 73 z X
\ 0 \ 0 ' i- - § k 73 § 0
§ z . , . > cc m
2 P. m i- . o
?to
■_ 0
730
C 1
§ 0 000000 . )
\ z z §22 § § §
mm ■ o
a 0 o E 'CP -013z
\ z ., 00E
§ -1.1 73 2
-I z - m
� r 0
PR4, �
�� r CITY OF PRIOR LAKE 3-� Date Recd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
/o , /
��'vNESD�
1. Pink File PERMIT NO.
2. Green City /
3.
-
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
6aA25 5hGrC? 1 rctr /k.). - RAS-2S
LEGALD� CR TI N(office use only U
LOT BLOCK A ITION PID Z,S= /25 o/ -a
OWNER p n
(Name) (4. N' La.u. COL 8e-1 ( (Phone) (PIA- c-f- CJ /I
(Address)33(.05- 31(Y0,(i 1 rai I toe Pr I'or Le1,,u,) 6O 37g-
_
APPLIC /� J
(Name) T Gi(.�C-1 C tX Sq� �S �}eJ (Phone) vl �}j' '7 1 g(.0
(Address) Lig-10i) 5 ' A /f _ / ll 27�
(A,• -ss) ( ityy) (Zip Code)
(Contact Person) LO( / G S ...6k„ n �
1 (Phone) "l59 -� -/8--(0 O
APPLICANT SIGNATURE' ji". ' % �v .) °C DATE - o - 5` *
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION REPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL � -La c2 IC FUEL Ct,C-)
FLUE SIZE RETURN OPENINGS INPUT OUT T
TYPE OF SYSTEM HEATING OR POWER PLANT
['Warm Air Plants PLEASE NOTE: Air Conditioner
❑ Steam Units and Fireplaces Cannot Encroach
['Gravity Hot Water
❑Mechanical ❑Radiation into Required Side Yard Setbacks.
❑Air Conditioning ID 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 $49.50
Estimated Cost$ Building Permit #
HEATING PERMIT FEE $ `T C{ ,
STATE SURCHARGE $ 1.00
TOTAL PERMIT FEE $ 5(0F,
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid `� .�
C-0 Receipt No ///�
/
Date`1(�. )to By .5257
Building Official Date
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372