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HomeMy WebLinkAboutHeating Permit 11-1033 CD �� § § ] a�� k rc ii ■w z .., _ r 2 \ \ z > aaa� 2 2 ■ E2 E2 � a g p §0 0 . w 62 z k 000000 w ■ o p w z . ^ § " 2 1 m k § 2 f r: k 2 / 8 § � �" k 1t Q § « 0 z ■ z = = s z 3 § / ( § | 0 ° a §Iw�g ' @ � o 0 z I )g � § k w § OOOO E 2 § § li k « k § § wt m g r. 2 % \ § w q S �� � §© � $ 2 , o w . ( 4 E z E & 2 �° L _, % CL ca � o � _ ■ � � « 2 - w Z re z k a k k \ E° Q $ § § 2 �� � ■ ■■ 0 .O 0 f pd 33 « 0 a 000000 U N11 — ugta — f, (it) RIO CITY OF PRIOR LAKE Date Rec'd � HEATING /AIR CONDITIONING/FIREPLACE PERMIT v INNEsoo 1. Fink F PERMIT NO . 2 Ye e c ity // ' / 0 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 1 &blt, t,cd " LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PM OWNER '-- �5 p , u�,�� �7 (Name) l er1,s , a 1 w (Phone) (Address) ) 41 LcL ,' 0 - j c (1 C( 1 l2 f J " I �1 53 ( N am ) ANT �n (Phone) '1112 ,I MO ame Pu b � (Address) 3\T) WV \ ) ) , IJV� 1 tc�v k ) 1 v � 1 \ � 5 -c51 � r a$dtess) (City) (Zip Code) (Contact Person) _ _! I.M,. all f , 1 ► 1. ' P (Phone) l�[ . ' ( 9 .- t) APPLICANT SIGNAT ' ∎� �..A �J� �l� . DATE �: I • APPLICANT PLEASE OMPLETE BELOW :NEW CON TRUCTION 4 AS PLACEMENT ❑ ALTERATIONS FURNACE MAKE AND MODEL 11 1n.. 6 to 1 WV FUEL I •i FLUE SIZE RETURN OPENINGS INPUT OUTPUT 4 TYPE OF SYSTEM HEATING OR POWER PLANT DWarm Air Plants PLEASE NOTE: Air Conditioner ❑ Steam Units and Fireplaces Cannot Encroach ❑Gravit ❑ Hot Water into Required Side Yard Setbacks. Mechanical 0 Radiation Fireplaces with Box Additions or o li . ir Conditioning ❑ Special Devices III Vent. System 0 Other Devices Cantilevers to the Outside of Buildings 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) $ $644 50 Residential, AC Only $49.50 The Minnesota Statutes § 326B.14 Fia4im8 �tad Cost $ g'3 , Building Permit # "SURCHARGE" has been extended I` until June 30, 2013, HEATING PERMIT FEE $ L H.✓ ' _ The minimum surcharge for a STATE SURCHARGE $ .. - J!5U "fixed fee" permit is $5.00 TOTAL PERMIT FEE $ 6 L . S This Application Becomes Your Building Permit When Approved Paid 5 -4 .s - 0 R eipt No./ 4.7 Date - C .(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