HomeMy WebLinkAboutBuilding Permit 11.815 Heating i
0 4 v RtO CITY OF PRIOR LAKE Date Rec'd
HEATING /AIR CONDITIONING/FIREPLACE PERMIT 8.22. //
en-e U/ / //. o74-
4 ,41NEsa t t, x. p rr< J / PERMIT NO. / 4'
3. Yellow Applicant s (/
Masse type or print and sign at bottom)
ADDRESS / ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID ZS 4-'7+ 00 ( . 0
OWNER
(Name) t ,!1 / 1- T_ A hi z.... 7 (Phone)
(Address) 76.5 /J e C =. A, / - 40e CT . /L �.., / � e � I� Al SS Y Z 7
APPLICANT /
(Name) / r e e r.,G, .,,,,t - a / (Phone) 744 3 78 6— 6 s 00 •
(Address) 3/0 Z- /U 3 1-41 E ' /! Z Li.:.ht , MAI .-i (714/? .
(Address) (City) (Zip Code)
(Contact Person) _ e rr ' (Phone) 6 (2 - 36 `1 - / 7 % 8
APPLICANT SIGNATURE . _ �� DATE v / — /(
APPLICANT PLEASE COMPLETE BELOW
ONEW •NSTRUCTION ❑ REPLACEMENT AA LTERATIONS
FURNACE MAKE AND MO! L FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT ,
Warm Plants PLEASE NOTE: Mr Conditioner
St eam Units and Fireplaces Cannot Encroach
DGravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation
[ ]qir Conditioning Special Devices Fireplaces with Bo: Additions or
r � Cantilevers to the Outside of Buildings
j Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi - Family I% of job cost Residential, Gas Fireplace 549.50 •
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) 564.50 Residential, AC Only $49.50
Estimated Cost $ a 6 Building Permit #
The Minnesota Statutes f 3268.148
"SURCHARGE" has been changed for one
HEATING PERMIT FEE $ BO i S year effective
STATE SURCHARGE $ 5.. 0 CP July I. 2010. until June 30, 2011.
TOTAL PERMIT FEE S 9s, 50 The minimum surcharge for a "fixed fee" permit
(Office Use Only) is Ifs beginning July 1.2010
•
This Ap, ratio , / s . filf 1 Your Building Permit Wh , Ap . roved Paid Recei o.6
Li ' e, ril Date
x idles • 1 t e Z2.1/ '
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 /
4646 Dakota Street S.E., Prior Lake, Minnesota 55372