HomeMy WebLinkAboutHeating Permit 11-0956 5 CX ❑ 0 00000 0 _ 0 > 20
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O i Rio �' CITY OF PRIOR LAKE Date Reed
HEATING /AIR CONDITIONING /FIREPLACE PERMIT
v
INNESo'cP 1. Pink File
2. Green city PERMIT NO. // .- (� �0
3. Yellow Applicant ` !
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
n Fre nmal A\r( KI (kJ
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER .R,�, /� n ( ^N -
(Name) l� 1, 1 CXX Phone} 4 —C N 5 Z-C
(Address) \5 3 Tir I iWYk I ► - C 1V u, PaitY Lcdo i kAn ; 53 -)-
APPLICANT
(Name) 3URNSVILLE HEATING & A/C, INC, (Phone) ° S - 2A -CCC3
3451 W. Burnsville Parkway
(Address) Suite 120
Bu rnsviltA, s 5337 (City) (Zip Code)
(Contact Person) (1 DLO ci_,EtI\2j\2LYO(±\(Xfl (Phone) ,
APPLICANT SIGNATURE ( }1
DATE C --- 1 f
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION [REPLACEMENT ❑ ALTERATIONS ``��
FURNACE MAKE AND MODEL N(LA 33")(11-U01-( 9( 00 FUEL \.7E
FLUE SIZE RETURN OPENINGS INPUT % c OUTPUT 13 !t
TYPE OF SYSTEM HEATING OR POWER PLANT .
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
iN Mechanical ❑ Radiation
Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
❑Vent. System ❑Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
- I N CU-1(.1A . 1 l Qkfl( (hi `kAd I. 11 (1 -4 S .
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
t ne ivitnnesota statutes 9 Jztus. t4t5 t $ Building Permit #
"SURCHARGE" has been changed for one
year effective ;ATING PERMIT FEE $ 4 t
July 1, 2010, until June 30, 2011.
The minimum surcharge for a "fixed fee" permit ATE SURCHARGE $ ?•_ )
is 51, beginning July 1, 2010 1 TAL PERMIT FEE $ S--1 ,
This Application Becomes Your Building Permit When Approved Paid - --- / 57) Re • t No. / ¢ 4
Date 9, i / / /
Building Official Date •
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372