HomeMy WebLinkAboutAir Conditioning Permit 11. 0566 -
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pxI CITY OF PRIOR LAKE Date Reed Cr,,,, y -,,, ° HEATING /AIR CONDITIONING /FIREPLACE PERMIT
4 1,1 Eso 'Ct' I. Pink File PERMIT NO.
-:1 O�� 3. Yellow Applicant % , 2. Gteen City
- 2 5
(Please type or print and sign at bottom) � C `
ADD SS ZONING (office use)
4 GO'JCl5 V . ,0(ICJ
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Name) WNER JCYcA✓1 V 1 p (Phone) ( )/9(P - 9(19 WO
(Address) ``7' 155 A)-(„1.1C( 'S V ,{260 •
APPLICANT SEDGWICK HEATING & AIR CONDITIONING LLC
(Name) 1408 Northland Drive Suite 310 (Phone)
Mendota Hvi hta, MN 55120
(952) 881 -9000
(Address)
(Address) (City) (Zip Code)
(Contact Person) a,rn C , (Phone) r
APPLICANT SIGNATURE a ( `7 J V • DATE (Pig( c� o
APPLICANT PLEASE COMPLETE BELOW
(/► DNEW CONSTRUCTION REPLACEMENT ❑ ALTERATIONS
F E MAKE AND MODEL Y6-- / 4 - a)O 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 0 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 $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ -4vl , 53 Building Permit #
The Minnesota Statutes § 32613.148
HEATING PERMIT FEE $ y 56 "S<<RCI iARGye has been changed for one
year effective
STATE SURCHARGE $ 8° July 1, 2010, until June 30, 2011.
TOTAL PERMIT FEE $ - O _ T he minimum surcharge for a "fixed fee" permit
(Office Use Only) 7, Is f, beginning July 1.2010
This Application Becomes Your Building Permit When Approved Paid 53/6-1) Rect No. 6 77 1/
Building Official Date Date -- ( / / Iii •
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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