HomeMy WebLinkAboutHeating 07-0024
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I. 17. Df)
i ~~~"w J~iicant I PERMIT NO. 07. 0 out-
ZONING (office use)
7A/. .s,W,
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
~
PID
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~
(Address) 3 0/'1 ?
(Phone ft'S;)..- <Yi7t"'7 - 1/ L./ /1
w. S~ iJ
APPLICANT . ~
(Name) (;.2M '~ ~
(Address) 6t?/S' /i/t -I( ~ tJ
(Address)
(Contact Person) ~
APPLICANT SIGNATURE
(Phone) 95'~;0/ -SCf3~
a~tJ~ t~h~- HlU '<)~/~
~ ~ (Zip Code)
(Phone) f1s.r- 0/--.:593:J-
/~
DATE //
APPLICANT PLE SE COMPLETE BELOW
DNEW CONSTRUCTION EPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL ...f'~tu~ tI(Jrl;; -tJqfr1tt/5 FUEL "7ilt .Lk~
j I
FLUE SIZE..3 RETURN OPENINGS INPUT c:r~ ~c,l) IJ1q OUTPUT ~ ()t:t:)&rt
TYPE OF SYSTEM
DWarm Air Plants
DGravity
~Mechanical
ir Conditioning
Vent. System
HEATING OR POWER PLANT
D Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
Fireplaces with Box Additions or
Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64,50
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
wot). Cf2-
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
~,~6J2
.50 A:1I
q'p- T"l6 #. ~
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
40.00
1.11,Oe
5/3Co
Buildinl! Official
Date
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372