HomeMy WebLinkAboutBuilding Permit 13. 123 - furnance 1_,
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TRIO CITY OF PRIOR LAKE Date Rec'd
A ° i .e HEATING /AIR CONDITIONING/FIREPLACE PERMIT
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LEGAL DESCRIPTION (office use only]
LOT BLOCK ADDITION
PEP
OWNER
(Name) k ' ► ► / i •10 (Phone) �� " A', ��i
(Address) C' i1 aN `-ems R :
,
APPLICANT
(Name) .V HEATING & AIR INC.
5182 WEST BROADWAY {Phone}
(Address) CRYSTAL, MN 5542g ,
(A 763- 535 -2000 (City) (Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE DATE
APPLICANT PL ASE � COMPLETE BELOW
ENEWr CONSTRUCTION "�. PLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL 1. Y1 C FUEL
FLUE SIZE RETURN OPENINGS INPUT 1 C'OO OUT '
TYPE OF SYSTEM HEATING OR POWER PLANT
►! • arm Air Plants PLEASE NOTE: Air Conditioner
❑ Steam
Units and Fireplaces Cannot Encroach
%Gravity 0 Hot Water
❑ Mechanical ❑ Radiation 4 into Required Side Yard Setbacks.
it Conditioning ❑ Special Devices F with Box Additions or
Cantilevers to the Outside of Buildings
11111 Vent_ System ❑Other Devices
FIREPLACE MAKE AND MODEL Require a Building Permit.
FEE SCHEDULE
y 1 % of job
Industrial, Commercial & Multi-Famil cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions &Alterations
Residential, Heating Only (New Construction) $64.50 0
Residential, AC Only $49.50
Estimated Cost $ Building P ermit #
The Minnesota Statutes § 32613.148
HEATING PERMIT FEE $ "StRCI1ARGF" has been changed for one
year effective
STATE SURCHARGE $
1 . July 1. 2010. until June 30, 2011.
TOTAL PERMIT FEE $ Olt, 50 The minimiun surcharge fora "fixed fee" permit
(Office Use Only) is 5, beginning .July 1.2010
This Application Becomes Your Building Permit When Approved Paid s Receipt No. ii
Baildine Official Date / ' ` B
Date /�/ � -
24 hour notice for alt inspections (952) 447-9850, fax (952) 447 - 4245 �✓"
4646 Dakota Street S.E., Prior Lake, Minnesota 55372