HomeMy WebLinkAboutHeating & A/C Permit #12-171 y O�[O C) OOOOO❑ � O D =c�
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�,�� �� HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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MI�NES��P t. Pink F�<< PERMIT NO. J Z_/��
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j � .. .'. 3. Yellow Applicaot �.
Please e or 'nt and si n at 6ottom
ADDRESS ,._- " ZONING (oe�'ice �Se) �
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LEGAL DESC TION (ofEice use only}
LOT BL CK ADDTTION PID
�aW�NER �� (,� -�, ` 1 V f l.� (Phone) �� � ° � �1������ .
(Address} -
APPLICANT G.V. HEATING & AIR INC.
(Name) (Phone) •
�A�dress) CRYSTAL, MN 55429
cAdd�67i-5 t���r) cz� coa��
(Contact Person) (Phone)
APPLICANT SIGNAT`URE � �? / 5 DATE ��
,
� APPLICANT PLEA E COMPLETE BELOW
QNEW CONSTRUCTZON REP ACEMENT ❑ ALTERATIONS �
FURNACE MAKE AND MODEI. LL� � �'� � V ' v FUEL ��_
F'L E E RETURN OPEN G INPUT OUT!'�
U SIZ IN S
TYPE OF SYSTEM HEATTNG OR POWER PLANT �
�►arm Air Plants PLEASE NOTE: Air Condiiioner
❑ Steam Units and �repla�es Cannot Encroach
�crravity ❑ Hot water into Required Side Yard Setbacks.
❑ Mechanicai ❑ Radiation �eplaces with $oz Additions or .
rc Conditioning � Special Devices
`� Vent. System ❑ Ocher Devices Cantilevers to #he Odtside of Buildings
I�e�uire a Buiiding Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commerciat & Multi-Family 1% of job coat Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $44.50
Residendal, Heating Only (New Construction) $64.50 Residenciat, AC Only $49.50 .
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Estimated Cost $ �, Building Permit # �
r , f � The Minneso#a Statutes t 32GR.148
�� �!' "Sl1RCf-IARGF.;" h�s been cbanged I'or one
HEATING PERMIT FEE $ year e'ftcctive
STATE SURCHARGE $ -� July l. 2!)10, unti! ,luqc 30, 2(!i I.
TOTAL PERM�'I' FEE $ The minlm�un sorchar�e for a "fiaecl fce" permit
(Ot�ce Use Ottly) is „S',.�, be�ioning.)u!y 1.2DtU
Thtis Applicaiion Becomes Your Building Permit When Approved Paid ��, � Receipt A[o. S�
Date � � � , By '
Buildiae Official Date �
24 honr notice for ait inspec4ons (952) 4A?-9850, tax {952) 447-A245
4646 Dakota Street S.E., Prior Lake,"Mtnuesota 55372