HomeMy WebLinkAboutAir Conditioning Permit 12. 0563 N 0 0\ 0 0 0 0000 = 0 0 yn
n O ¢ 0 0 0 0 y 'n - � 88 -n� 'n 0 m 0 m 4
00 g m m O
b > ° XI 7 X 3 rc3Z� ,n N 0
* 1... n n N M y �g ° > z to Ov
to . > Z v O >O z�
S
HLU z M - 11 1:1
lZ7 z xx o o `
❑❑ ❑000
41 x m rn m fTI
c * 3 r � }
p 0 rn n.I 1 \� `' I
•e Z v zoo m Z P 0 n� 0 `
, 0 6 O r II O 70 -1 . \ c o
A
Y m ,,\\
c n Cv
m ❑000❑
Z z Az, -n i 0 ' ~ F.
R. < 0 r 1v � * 1 m
en z / (
F i 71- z m
0 Z 2
1 r
R `
Al2.- 2,6v .
1 5 : V 50 S../ I
rr CITY OF PRIOR LAKE Date Rec'd
° " r i "'� HEATING /AIR CONDITIONING/FIREPLACE PERMIT
V: '^ , g
d'' VESO° 2. Oran cry PERMIT NO /2_ . i3
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS , `^ 1 v c ( ZONING (office use)
LOleLI 5 /U�
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER 0 152 39
(Name) �,� a�� ( Phon e)
(Address) L I ao Li 3 rCSu. ha \Y) C\Vc\
-
APP 1 r op
Q t (Phone) S2-7 U - 1 Vl) �J
� , r •
,r� Q
(Address) 1 Z.:" � \\ A �.�f 1 U0 k 1 3 B L) Y 1 1 C J V t 1,Q S 3 3 (Address) ( Ci (Zip Code)
(Contact Person) 11 U, A. rA ti 1, ' (Phone) J 2 • - 1000
4.
APPLICANT SIGNATURE Lk. ` DATE S INE l
APPLICANT PL AS COMPLETE BELOW
❑NEW CONSTRUCTION PLACEMENT go ALTERATIONS
FURNACE MAKE AND MODEL ") r - C FUEL
FLUE SIZE RETURN OPENINGS INPUT GPI A `y OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air Plants PLEASE NOTE: Air Conditioner
❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water
❑ Mechanical ❑ Radiation into Required Side Yard Setbacks.
❑Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
❑Vent. System E] 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 & AJC (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 if
The Minnesota Statutes § 32613.148
( C "SURCHARGE" has been changed for one
HEATING PERMIT FEE $ `7 -/ • J year effective
STATE SURCHARGE $ 5 . .50 July 1, 2010, until June 30.2011.
TOTAL PERMIT FEE $ 5q. SC) The minimum surcharge for a "fixed fee" permit
(Office Use Only) is 5.�, beginning July 1.2010
1
This Application Becomes Your Building Permit When Approved Paid 54 4 s ) R ceip No. ( 0 4j„
Building Official Date Date / 7. ( Z _ B _ `� `r'
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372