HomeMy WebLinkAboutHeating Permit 11-0840 5 0 ❑( 0 00000 0 = 0 > y
m 0 0 0 3 - izc z n m00 0 m m 73 C m0
b r o X 73 X 77 E T -1 Z c cn n -4 '
nn m m y m 1n r ,--3z -.4
O O-o
Z - U z -
--I m
t O O -1
∎b o O n z m 7\
M z -a m
m
• m X 0 0 00000 (R. •
Z m m m ry
X c c
13 o m o - i3 m i3 1 v 0 CA
• m 1� w w
C) N z z== � z x zz � � _
C m m -1 1 >000 0 3 -1 m
, C7 O rTOO u :1 , r C
NI 0 o z z c c V' m
• o CO � �� m
• z m
4. X V. 0 f"- .
t• O m
cn 0 0000 0 0 `�� r— o
• Z z N, nrnmo 1 III" R° O rvvv0 �'�' 1\ .�
t8 z >mmZO
i C \ 16, t
r
1
YRIO CITY OF PRIOR LAKE Date Rec'd
° : " :,, e HEATING /AIR CONDITIONING /FIREPLACE PERMIT
�6 ,phi
A P
1. ink lice 0 4,6
�NES° . Green city PERMIT NO.
3. Yellow Applicant / � .
(Please type or print and sign at bottom)
ADDRESS ZONING office use)
A/ . rd m C.4. St%
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER ) 052-- 43 - 44 7
(Name) r_ 0 a .. .AI (Phone)
5 �� 0 t.. tf' a �f`�OZ11Yl ` 4 . S • f •
APPLICANT
�_� J ,�/�
(Name) I,/ J+CC/�y � � -\ c 4 f \- v- (Phone) . c452_-4-31 1 I •
(Address) . • .. W • _ A - i 4 • 0 I J 5 J 1 2-4 -
(Address) (Ci ) (Zip Code)
(Contact Person) a(lne etheAl (Phone) Gi Z - - SS I
APPLICANT SIGNATURE LAW i L/. ' . L! _ . e DATE
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION cm REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL C(12_,X, 3SPIA\1( fj ) FUEL I06:47 (
FLUE SIZE RETURN OPENINGS INPUT i "MOUTPUT l(a ICOCIB'f )
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.
❑ Mechanical ❑ Radiation Fireplaces with Box Additions or
❑Air Conditioning ❑ Special Devices
❑Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi - Family I% 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 #
The Minnesota Statutes § 326B. 148
" S(JRCI IAROI. " has been changed litr one
HEATING PERMIT FEE $ year effective
STATE SURCHARGE $ .50 July i, 2010, until June 30, 2011.
TOTAL PERMIT FEE $ GO The minimum surcharge for a "fixed fee" permit
is SS', beginning July 1.2010
(Office Use Oniy)
This Application Becomes Your Building Permit When Approved Paid 54_ SD Rec ' t No. 6 ( i
Dat ` . � I By
•
Building Official Date • j�(Q '
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372