HomeMy WebLinkAboutHVAC Permit 09-0427
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CITY O~' PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~i~~n ~I~y I PERMIT NO.C? _ 112'
3. Yellow Applicant , / '-f -L
(Please
ADDRESS
ZONING (office use)
o cu\t"
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
~=R (y\~ \\'OJ"~S
(Phone) (P? - 578 - t{~-, ,
(Address)
APPLICANT .
(Name) \\~\<.e('\ C~~~~~~
(Address) B'\lf1 \-\OH~ c!..f'\~~
(Address)
~t"\:
(Contact Person)
(Phone) (ol~" s:c:Jr- 9O\Qb
~~Q.Q. 55"'571
(dty) (ZIp Code)
(Phone) b\d-" S'o~,9~q b
DATE -;).5'- E>
APPLICANT SIGNATURE
APPLICANT PLEA COMPLETE BELOW
DNEW CONSTRUCTION REPLACEMENT D AL TERA nONS
FURNACE MAKE AND MODEL \{ sc... \0.0 A FUEL ~d-
FLUE SIZE
----
RETURN OPENINGS
INPUT lS'QOOO
OUTPUT
TYPE OF SYSTEM
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
o Steam
D Hot Water
o Radiation
D Special Devices
D Other Devices
PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
Fireplaces with Box Additions or
Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
Estimated Cost $
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$49.50 minimum
$149.50
$64.50_L': 0
~S-~~O
8{ -.
$49.50
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$49.50
$49.50
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
55.'5"0
.50
5{o.00
n Be omes Your Building Permit When Approved
Paid
Receipt No. lJ827
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
JUN-11-2009 THU 02:44 PM GusLave A, Larson (PLY) FAX NO, (tj,:H)qlU~lO
L?iJ:,. Gustave A. Larson compan~P) BASEMENT BAR AND tMttf A TION
WHOLESALE HVAC, Rf;FRIGERATION AND CONTROLS
I. Uti Ul
CONTROL NO.
PLYQ085774
13200 10TH AVENUE NORTH
PLYMOlITH MN 55441
CUSTOMER NO.
S90Q72
DATE
6/11/09
PHONE 763-546-9508
YOUR ORDER NO.
HORI~ON CONTRACTORS
SHAKOl?EE
MN 00000-0000
CUST PHONE #: 612-508-9296
FAX #: 952-461-3484
TRAN YSC120A3EHA002R 10'1' RT wise 6224342 1
230/3 ELECTRO MECH CONTROLS
HONY TH5220D1003 2H/2C DIG STAT 3447834 1
STANDARD :aCKLIT nlSPLAY
ROBT 2650-660 SMOKE DETECTOR 4250105 1
IONI Z. ORDER FM AIR FRODDe
ROBT 0533 SAMPLING TUBE 2.5'-5' 4250040 1
ORDER FM A1R PRODUCTS
PRIC'9 VALID THRU 6/07/09 EXCEPT FOR REF IGERANT COPPE I COPPER F~TTING8
SHE. T METAL PRODUCTS AND SOLDER
TOTAL
5,550.00
,
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