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HomeMy WebLinkAboutBuilding Permit 11.0557 = O O O 0 000000 7 0> 20 n o k X X k m>c m q k §9 k r k k/ \ m § §§ƒk § 2 % t *> q % r m 0 -- 2 3 & w @ cn§ Z z o 0 w : Q f ••• 7 0 § 2 0 k 1 0 2 r -1 71 TJ 1:1 m q 00 000000 P| 0 Z §§§ M r " >M r a r c cz \ i m CA �� \k % k m 4 . o z ' * m § 0 1 ® ` >000 0 ■ m n z' 0 0 r -n oo § P c % § \ z z z k r 0 z ' m � m / I m § q 0 � ' )00000 • q > z Azz 1 � ■ ■ -4 ® o Cmm■6 g m R. �z ��� % 0 ' � §m 9 m � ) '2 � � ® / § w -- z � PRIp CITY OF PRIOR LAKE Date Rec'd C) 4) HEATING /AIR CONDITIONING /FIREPLACE PERMIT M 41INNESO 2 1 . Gr pineen k FCit y / PERMIT NO . / -' ! 3. Yellow Applican / /// (Please type or print and sign at bottom) ADDRESS � \\szDr t ZONING (otiice use) C lUC 1 r I LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID O f -- u. C), c � V \r' ,I (Phone) 6`.- - Q - Ro (Address) � CALk W (A \tu ► G \� ( (1 e L i) ,, i ..k ,`,,, S (,3 h APPLICAN S � `i �'\ r © ` (Name) ll'�i � ^ �`� (; (Phone) ( " 1 \ 1- O \c V\ (Address) 1 C \ g% \-3 \ <.1/4)■1►.‘ A \J °. e r 0 v- WC 5 -S. A n� t ( - Address) (City) (Zip Code) (Contact Person) v Pay 1-� c i �1 R �,\ s k.. (Phone) 1-C av 4 7 -•? ‘ A 4 APPLICANT SIGNATURE ‘`� DATE – a 1- \ 1 APPLICANT PLEASE COMPLETE BELOW IIINEW CONSTRUCTION JkiREPLACEMENT ❑ ALTERATIONS FURNACE MAKE AND MODEL 55 (- \l (IA 6s) 0 FUEL 0 FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner ❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach EGravity ❑ Hot Water into Required Side Yard Setbacks. ❑ Mechanical ['Radiation ]Air Conditioning (5T _� ❑Special Devices Fireplaces with Box Additions or ['Vent. System 1 ? cg ANp10 ❑ 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 (13 Estimated Cost $ S -C NJ - Building Permit # HEATING PERMIT FEE $ STATE SURCHARGE $ S 40 TOTAL PERMIT FEE $ 5 s%. (Office Use Only) This Application Becomes Your Building Permit When Approved Paid 5 -lg .5 Rec t No. 6 3/6 z.... Date G 7 � j Building Official Date Z/i t 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372