HomeMy WebLinkAboutAir Conditioning Permit 09. 0504 J
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ic rIPR/0 4 I 1 g I �f ��I77 Cloo � CITY OF PRIOR LAKE I3�t�R
HEATING /AIR CONDITIONING /FIREPLACE PERMI ' JUL 13 2009
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YPink Pile Ci PERM ` 0 '09. O
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3. Yellow Applicant 0
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
14-1 q., Maple i Y :I j SE
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) N CO fJ Arl l'LQ_ PC717 tr (Phone) q52- yam -1, -v l GS
(Address) f t I')ir - 7 - 1-4..,0 & &
T_
(N PLI) co 11 Led / i k (Phone) 65 'Co O Z Z
(Name)
(Address) !� 2-I? q.. /4"V` aLVYU Yl 7JY\ 5-5-.324
0.AI/3 (Address) ty) (Zip Code)
(Contact Person) _ 14S- (Phone) IPA r L ( -0()4-0 0 2Z___
APPLICANT SIGNATURE A .t ► DATE �` 1 U' U
APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION %REPLACEMENT O ALTERATIONS
FURNACE MAKE AND MODELl'GC KL1 72L Hl 2-& 'b FUEL
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
DGravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation
Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
OVent. System ❑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 #
HEATING PERMIT FEE $ y R • 5-
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ 50 °O
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid ...0 6 0 Receip o A
Date . 13 By.
Building Official Date � n � •
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372