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HomeMy WebLinkAboutHeating Permit 12-0208 2 1� t - U W � i §� 0 � k � _ O��q� $ ■ / : U E.� g © M 000000 0 3 NI 0 v \ IIJ § i.: 0 2 0 5 i d k 411111‘. . L. ■ 0 0 LT � . z Q 0 B III z so 1 z & z _zz2$ 2 o. c ®_0 w �iw oo ii / \ co . :E :c U �� w W § w e � 1 Q Q■ IA/ a■ ■��■ z % 0 00000 2 § 2 INN O. a � e • \ -I \ 2 � 5 p z p ti k f e k Li] U g U 1 ' z �. ib Q z § Z �� ® 01- 2 g4 �o 0 � 10 0 e (9 w && 2 J / oui §■ Z 8 § g W« I- M 0 0 0 E � a § 0 & o O O 0 o 2 0 1 000000 U „ 4vRfo� , CITY OF PRIOR LAKE Date Rec'd HEATING /AIR CONDITIONING /FIREPLACE PERMIT Zr rt U (ri I/VNESDl 1. Pink File PER NO. /� 2. Ye FCity w Applicant / 7 / f� 3. Yellow ` (/V (Please type or print and sign at bottom) ADDRESS ZONING (office use) / 7 S-5— 3 gi � GI LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) 1 ) ) 1� ill L e M /! D fit b s 17 (Phone) (Address) APPLICANT-, (Name) I 1� 1 r e_ 1 S (Phone) 9.V- 7-en 0 (Address) / .sry -bbl C £/rX di- T/- /D./ i - . A. SZ 37..? (Address) (City) (Zip Code) (Contact Person) ..._41111 1 4 1 / (Phone) r/ APPLICANT SIGNAT • __, _� I7 DATE 3- APPLICANT PLEASE COMPLETE BELOW ['NEW CONSTRUC N ❑ REPLACEMENT ❑ ALTERATIONS FURNACE AND MODEL G / k _ FUEL RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT ❑Warm Air Plants PLEASE NOTE: Air Conditioner ❑Gravity 0 ❑ Hot Water Units and Fireplaces Cannot Encroach into Required Side Yard Setbacks. ❑ Mechanical ❑ Radiation DAir Conditioning 0 Special Devices Fireplaces with Box Additions or ['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) $64.50 Residential, AC Only $49.50 Estimated Cost $ Building Permit # The Minnesota Statutes § 326B.148 HEATING PERMIT FEE $ "SURCHARGE” has been extended STATE SURCHARGE $ .50 until June 30, 2013, TOTAL PERMIT FEE $ The minimum surcharge for a (Office Use Only) "fixed fee" permit is $5.00 This Application Becomes Your Building Permit When Approved Paid 94 sl) Rec No. 6 s - 3 2.7 Dat ‘3 .� G By Buildine Official Date �/il r 2 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372