HomeMy WebLinkAboutHeating Permit 15-0030 y ❑ 1:3)F4. C) 000000 S o Dv No
n 0 a 0 0 0 3 =ixen ° )0 m m m m0
b a G „ „ 3 mPFE29 Z m y �m
tn r m y r11 Z S = 0Z o y pm
10 . to (A 0 Z z Z r�
0 •• moi! Y p cs Or
0
, lik o 0 ► z ..CJ mo
o a m
hi X r 0 :‹ a
73
Z 73 C00 C00 0 0000'0 -.
O -4 z m 0m mrlcfi> E 13
mr P"-
`em ! X m m = W -E1 C) Cl))
'� 9 Cl)
0 -n v 0 Z Z in
S � Z A. z 2
* C) m O riOO 0 3 0
„ 0 0 Z ZCC Z r.
(� o = , m r -0 % a m
m
a z 0
y ` ❑*000 ❑
m w „ v
2 i
R• < O a LAmmz " C U m
co z
-+ r O
t S-'-4 . g0
PR/0 CITY OF PRIOR LAKE Date Rec'd
a,rii,V HEATING/AIR CONDITIONING/FIREPLACE PERMIT / '13
' IC
P 1.Pink File PERMIT NO. _ ,
Applicant
4vNEs� 2.Green City /5 - ) }
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
1ytoci ; W 1` c4-S U e (--, Q U—) p u1^1
LEGAL DESCRIPTION(office use only)
LOTO BLOCK ADDITION PID c7/c - li . 9
10
OWNER
(Name) M a S k-e s (Phone) al S a • 2 7 0 'd 3 8 Co
(Address) 1c-1(09 3 W;1 d o U e L-J LILO
I
APPLICAW
(Name)_ r +0 H t-C -.D a A (Phone) ciS 1 ' �,3 S " -7 -1 -7 '7
(Address) —1 S�O i, UU a s k;n o -, A kie S Ed t,,, -P,-, ,v, kA tiJ LI L_- I
(Contact Person) S)a V a L (Phone) '
APPLICANT SIGNATURE 1, kl_ DATE \ I
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ['REPLACEMENT ['ALTERATIONS
FURNACE-MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
D Waim Air Plants D Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑Hot Water into Required Side Yard Setbacks.
DMechanical 0 Radiation Fireplaces with Box Additions or
DAir Conditioning lh'SPcciia�L ek r \ `'^ `-S Cantilevers to the Outside of Buildings
0 Vent. System DOther Devices s 'e L a �-- 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 Pennit#
HEATING PERMIT FEE $
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $ S ci .CO /o r a
This Application Becomes Your Building Permit When Approved Paid / .3 , /� Receipt No.4-44c,(' c
� /
C Date S C f.-5 V By ( �vw"
Building Official Date •
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 i
i