HomeMy WebLinkAboutBUILDING 05-1076
THIS FILE HAS BEEN
CLOSED DUE TO
INACTIVITY 4/18/2008
-~ r<.EQUEST FOR FINAL
INSPECTION SENT TO
(please type or print and sign at bottom) HOMEOWNER 10-06
I ADDRESS
~q~l . h){ Tra \ L
CITY OF PRIOR LAKE
HR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
;.:n ~:;y I PERMIT NO. 0 r- - '07. I
'.lIow Appltcant ..J /4
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT rt BLOCK ~ ADDITION
uJ~
PID 5-c;>..Q/J-OI -0
OWNER
(Name)
(Address)
(Address)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATING OR POWER PLANT
OUTPUT
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
oVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3s-. ~a
.50
L{O. e ()
lice Use Only)
~
I" / Z~ /os
, Date f
ReceiP~J'3 J ?
By
plication Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372