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HomeMy WebLinkAboutMechanical Permit 09. 0854 g 0 0 0 000000 0 > E n k 0 0 0 . 0 �on K -n II -n 5 § 8 S n g AK c m m n o k k -4 m B� §�k 0 0 d� q o e 2 0 z ■ R t K d § 2% § 2 c k \ on z �� hi O i §§ �� mm § xi 2 § § � E 000000 ki 4 i X q mm s -a ® * ■ \ z � � i§ m 0 a) 2 0 m / . z zz x z m 0 E 0 \ n \ 0 r-n§§ 0 § . a % 0 § z ■cc z C 0 g § I r 1 ) -0 P m = • 2 0 0 al n 0 0 m _ 0 . . 00000 i . i 0 0 ` Ok i kk XIO§ �m • 2 ;§ E ���� Pi \ a0 ci cr( 01 • Pi 4 i ® -I�q�C 2 I Z m ..1. ` r. 0 • F (Ri0 CITY OF PRIOR LAKE Date Rec'd ..fi x HEATING /AIR CONDITIONING/FIREPLACE PERMIT 1 b # 0 4 4'Nesol P Pink en City File PERMIT NO. Yre © 0 � V Q 3. Yellow Applicant - r . V (/ (Please type or print and sign at bottom) ADDRESS ZONING (office use) l a by L AY LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER M , i { [�J� (Name) I Qt (Phone) q)a "i/y5 7 v 1J (Address) APPLICANT (Name) fir'; 16 • — $ ' (Phone) 101a LSD9 0 MI (Address) q . 0 A A► A[ . . D ili • 1 !I. 11 a a LS 4i 5 3 (AT - ss) t (City) (Zip Code) (Contact Person) ∎ Al i MI rVI i. - . (Phone) APPLICANT SIGNATURE . r AILO, DATE APPLICAN ' EASE COM ' ETE BELOW ❑NEW CONSTRUCTION ❑ REPLACEMENT &LTERATIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT ['Warm Air Plants ❑ Steam PLEASE NOTE: ❑Gravity ❑ Hot Water Air Conditioner Units O Mechanical ❑ Radiation Cannot Encroach into ❑Air Conditioning ❑ Special Devices Required Side Yard [Went. System ❑ Other Devices Setbacks • _ - : : .) " 4i j 1 dro 4 1 NO1 an`L l! ) 0 00)0 FEE SCHEDULE Industrial, Commercial & Multi- Family 1% of job cost Residential, Gas Fireplace $39.50 $39.50 minimum Residential, Heating & A/C (New Construction) $99.50 Residential, Additions & Alterations $39.50 Residential, Heating Only (New Construction) $64.50 Residential, AC Only $39.50 Estimated Cost $ 51 a k CO Building Permit # HEATING PERMIT FEE $ STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ 50,00 (Office Use Only) This Application Becomes Your Building Permit When Approved Paid sb vt) R ipt No0 Building Official Date D a" ( mod / B • 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 16200 Eagle Creek Avenue, Prior Lake, MN 55372