HomeMy WebLinkAboutHeating & Air 13.188 R CITY OF PRIOR LAKE � 1 `
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1, 9 HEATING /AIR CONDITIONING/FIREPLACE PERMIT ( . /, ;, [; ‘,..),, f- i4 (1.- 4 c
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PERMIT NO. 0,9\ /..4 ( 2{
3. Yellow Applicant 3 - 1 V� J 1 �/leG'
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(P type or print and sign at bottom) T r 7
ADDRES 3077 Lake Haven Court N ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
•
Dave & Nikki Miller
a (Phone)
(Address) 3077 Lake Haven Court NW Prior Lake 55372
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A me A learwater Plg & Htg (Phone) 952- 440 -3779
•
19260 Mushtown Road Prior Lake 55372 .
(Address)
(Address) (City) (Zip Code)
(Contact Person) Susan Schlink (Phone) 952- 440 -3779
APPLICANT SIGNATURE DATE 2/20/2013
APPLICANT PLEASE COMPLETE BELOW
$]NEW CONSTRUCTION ❑ REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Mr Conditioner
['Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
['Gravity 0 Hot Water
0 Mechanical 0 Radiation into Required Side Yard Setbacks.
['Air Conditioning D Special Devices Fireplaces with Box Additions or
OVent. System D Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
Basement finish.. 6 supplies and 2 returns, 1 bath fan vent
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 $ S. 1) (4S Building Permit #
The Minnesota Statutes § 3268.148
HEATING PERMIT FEE $ "SURCHARGE" has been changed for one
year effective
STATE SURCHARGE $ .50 July 1.2010. until June 30.2011.
TOTAL PERMIT FEE $ The minimum surcharge for a "fixed fee" permit
(Office Use Only) is K, beginning.Iuly 1.2010
This Application Becomes Your Building Permit When Approved Paid 5. S y Rece' 0.6s/¢. L
Building Official Date Date 3 7 - (3 13
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24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372