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HomeMy WebLinkAboutBuilding Permit 12. 0036 - O ❑ & n 00000E - a o > - ] O 0 0 ��� x z R q1 k\ k k\ � rr'M k - z 7J / � trl 1- § §a . Z $ - 0 -4 P �k 2 t 2 /° Z 2 § G m. ) d a P § 2q M m \ 2 r© 7 -n \ m 2 q 000000 § § § (§ mr ® >m r s \ c c \ z i k \ § ■ � \ _ § m 0 \ \ 0, § § « >000 § 2 m '0 § a / moo § c § q � §k P m 0 0 k tt, e- ■ 2 �. = m 0 C313) m WOOOOO ` o ] > 2 $]I§§ 2 a n � mm�Q . (n G o . "u«� \ � � � / \ 7 ` m AI 11 ■ R 2 q § � t / m pRX CITY OF PRIOR LAKE V Date Rec'd o = Y Isk HEATING /AIR CONDITIONING/FIREPLACE PERMIT fil, a" 1NNEso0 " i !. Pink File --)1).- ,,,� ?7 i '+1 r 1 l c i -) 2. Gr city PERMIT N O . A / 1 3 3. Yellow Applicant Li (Please type or print and sign at bottom) ADDRESS ZONING (office use) 5 s7 s vi tsiw co 9 2 es- er S s v fi +-0-#A- 0-#A- 1 LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER ! (Name) WC J i 13ASWO '- H''\ C N1 - ACCA ' S 0 --711 (phone) (Address) ictiVN C A S r f APPLICAN T (Name) \1 (fr‘ - k-(=- P.FL )A -PrP 'PAC- (Phone) q'✓)- - EE -) 66 (Address) a2.2- 11 'LJ tc S i g\ s -. '1l'l _v 3 IJ fe-✓o0 > s, 7 ,1 Ni 5 5 (-4.94O (Address) (City) (Zip Code) (Contact Person) WV'- 4 1 rrs- 6 (Phone) APPLICANT SIGNATURE ( ( DATE 101/ G i I j APPLICANT PLEASE COMPLETE BELOW '—� i DNEW CONSTRUCTION ❑ REPLACEMENT 01,ALTERATIONS DySULSefSW■S FURNACE MAKE AND MODEL 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 ['Gravity ❑ Hot Water into Required Side Yard Setbacks. ❑ Mechanical ❑ Radiation ❑Air Conditioning ❑ Special Devices Fireplaces with Box Additions or ❑Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL FEE SCHEDULE Industrial, Commercial & Multi - Family I% 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 �.a Estimated Cost $ ( 0, :: Building Permit # The Minnesota Statutes § 326B.148 HEATING PERMIT FEE $ ( "St -IRCI- IARGE" has been changed lor one year efleetive STATE SURCHARGE $ 5- `'° X Jaly 1, 2010, un til ,June 30, 2011. TOTAL PERMIT FEE $ 1 05, c''`) The minimum surcharge for a "fixed fee" permit (Office Use Only) is S5, beginning July 1.2010 This Applicati fy1 I, o / 1 % . i ur Bti,1ding Fermi W n Approved Paid % Q Rec i No. 67 9 - 4 f,. 7 Afaii. I ti ►?i Date /- g ( By Buil. Joe Official v � Date • 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 Fv C N S5 ( .� 5�-� c-c- �> ti . MN-3 r+' - L-1 s S rGS S" C D.J -u 5 ) p . . c- i T L S .) cstr