HomeMy WebLinkAboutAir Conditioning Permit 10. 0434 - 0 0 0 0 00000 7 0> / j
k nn 2 to 2 m 2 m0
n o \ 2 2 2 c m a c g0 m xi q M O .
k r R m m m z � �°E z ® --
m r 0 0 ' 2 $ )®§® z-
% t ® > § -1 § 2 z §
? to 0 n q ® —1 0 co \ ° / z q§
�w
\ 7 3 r z
x -n -v
\ m q § 3 000000
Z , m m �§ "��§ )
2® %° x m I 0 co
\ 3 § 3 ) / Z\\� Z k z m
2 0 6 0 r -nqq 2® � E
% 0 03 I p r
% Z : m r m
/ 1 m \
\ 0 !�
» m 00000
\ z I cI$§§ §
/ < § .L § -0 -a® r
/ �0\
z »mm�2
§ % � �� r
: -- E m
� § 0
t 66
.56 }110 -6 r x r p CITY OF PRIOR LAKE Date Rec'd
° , 1' HEATING /AIR CONDITIONING /FIREPLACE PERMIT fir- ze,1
1
; f
��NES 2 . Pink File i O / 3
D 2. Green City PERMIT NO. 4
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
5 1 — ff Sec'erS (
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER � � flQ,
(Name) �'�. W �� R (Phone)
(Address) Na L3 , UV eh
(Nam l e.n2, �. (Phone) =-1c7- 1 L „ 1 Oo (-- (Name) � r ;� ( i � Phone y � ` L 1 3 1
(Address) 1 a M\ 1_ s a LI3 5 1
e- ) Address) (Ci ) II (Zip Code)
(Contact Person) ` A . 1 . ' hone) - 10 . [Ott
'��
APPLICANT SIGNATU =� t - �' 1.� �► _��� , DATE
APPLI • PL E COMPLETE BELOW
NEW CONSTRUCTION REPLACEMENT ❑ ALTERATIONS
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. - 1.04 ❑ Special Devices Fireplaces with Box Additions or
['Vent. System 4 On ❑ 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. Residential, AC Only $49.50
Estimated Cost $ (o 7 Building Permit #
HEATING PERMIT FEE $ 1 1 . q .
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ • OC
(Office Use Only)
This Application Becomes Your Building Permit When Approved , Paid i b n 1 cipt N O ? a
Date V f)
Buildin¢ Official Date 5 ' d (
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372