HomeMy WebLinkAboutAir Conditioning Permit 13. 0808 H }k d \
7 a�� $ ®
e M ■�� >
ti . o
$77� 0 z \ z
w WO c /
0 7 wo�� \ §
° oeoec��
o
\ \
L. \
W \ / w
o 6 §§ z 0 S
z o o 0 e
E 000< S ® 2 )
E z ce$ -i ??e ! I f o
3 0 w �$ SE 0 Z .4
a■ �
® Doi- 2 0 0� z
A � ■ � w
000000 o0 w \
ril 0 z 0 0 \
R z 2
o 0 2
«
UJ § § $ 0 0 k 0 CO @ # 2
z ® v E w
WO z D o w ® w w .
>:
• k 2 2 / z2 �a - 2 k \\ § < /
o E w 2 0 0� Z! 0 0 /
k % o$ 0 U. U. U. _ �CO 0 O O
2 2 o 1 000000 0
CITY OF PRIOR LAKE 5.` 50 ,) 614 3420696
o � Plti Date Rec'd
H HEATING /AIR CONDITIONING /FIREPLACE PERMIT
Q ■t) V' s —
si INNEso' c- ‘ 1 ' 1 Ginn Fie PERMIT NO.
�1 y l3 —,Si61(
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
) Pje-1,1 1 viirJ Is L YI V
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER D ovl
(Name) ► f 1 k CA/ k c e _ (Phone) ( 5;) .. 140- -
r vim C/
(Address) 7,j j Y 3 P A. Vii U 1 1,-, p m Ve-
APPLICANT r �p (' a (� 2 /�) �,
(Name) O f l (r' tk t' r1( cti y c . .- A �� i` (Phone) ! 52 1 l V!./' j
(Address) q l lie kill ' 1 1 1 0/ 51 t 1 / T V1 Sk S °3-
(Address) (City) (Zip Code) \
(Contact Person) KQ- I /A 1 Ai! Oh (Phone) ( Ail 9
APPLICANT SIGNATURE ■ _ 1 .4 - DATE 1 ]IW '
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION Z REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT 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 El 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 $ ' ' •
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50-
Rt,,,,otP.l Cost $ Building Permit #
The Minnesota Statutes § 326B.148
"SURCHARGE" has been extended HEATING PERMIT FEE $ 4 ' 5
until June 30, 2013, STATE SURCHARGE $ 0
The minimum surcharge for a
"fixed fee" permit is $5.00 TOTAL PERMIT FEE $ 5 .. 1/
This Application Becomes Your Building Permit When Approved Paid f j/ Receipt No. 1 9
Date �7/� By i
BuildinE Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372