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HomeMy WebLinkAboutAir Conditioning Permit 12. 1343 J 0 O 0 000000 ° 0 > ■n n 2 00 . 9IP q k m X m , X 0 0 m . � � k s. • 0 z ■ % 0 km % ! - . § 7 m \ 0 x 2 M © m i\ 000000 o §k m §�t�� .... itj o • 0 G % 2 0 0 o . zzx 73 z I E ■ _ q �' 0 O r -n kk 9 mn / mm O b 2 k q . . 0 m ?`S 2 o K 2 m oOOOO ■ § i n ' 0 ® f� MMM \ 0 e 2P § m 5im E @ -,f 0 m . r RI� CI TY OF PRIOR LAKE Date Rec'd I-, T e HEATING /AIR CONDITIONING/FIREPLACE PERMIT l / 1, / Z_ x V try /N NESOcA . Pink File l . Green Cit PERMIT NO. 2 .. / 3. Yellow Applicant / (Please type or print and sign at bottom) ADDRESS 4 z H e 40figu S-7- 7 ZONING (office use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER �f (Name) v` U Pt (Phone) (Address) (Name) CAN /, � (Phone) 7 f S a - TIC (� (Name) /� t /'' /G Yl / / �� Phone 7" /C‘ i // // S� 11 (Address) a a a �c% �/ S� lG' �. i �c�y , .n3 4 5 ( a Q (Address) (City) (Zip Code) 1 ) (Contact Person) (2 AP . c ® s , f (Phone) 5) -. S' f - /C APPLICANT SIGNATURE �-a — .w _ DATE il - PPLICANT PLEASE COMPLETE BELOW ❑NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner DWarm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach ['Gravity ❑ Hot Water into Required Side Yard Setbacks. ❑ , - chanical S ❑ Radiation Conditioning ❑Special Devices Fireplaces with Box Additions or • ent. System v 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 The Minnesota Statutes § 326B.148 Cost $ Building Permit # "SURCHARGE" has been extended until June 30, 2013, HEATING PERMIT FEE $ /irA 0 0 _ The minimum surcharge for a STATE SURCHARGE $ t--.50 cHkel E "fixed fee" permit is $5.00 TOTAL PERMIT FEE $ M�� This App ' k % on Becomes Your Building Permit When Approved Pa' i Receipt No. A rt ft)it- 164 ' 1 - 7 -12.. Date By B filing Official Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372