HomeMy WebLinkAboutHeating 06-0741
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
s~<~
'r''''iVE5 O'\!-
ADDRESS
/~
LEGAL DESCRIPTION (office use only)
LOT 1 BLOCK
ADDITION
OWNER
(Name)
(Address)
APPLICANT .-11 /.1
(N ame )'_:'_=_J2 I' ve 5 iCy Cd a- ea (t~ ~ II-d YJ1 e"
(Address) /43 q q fill fl f r Y1. (j 1 f(ll1 /tV ~ /
(Address) J
...
(Contact Person)
APPLICANT SIGNATURE
Date Rec'd
i ~:~~~w ~l~icant I PERMIT NO.C 6- 71 ~
ZONING (office use)
3P
PID 300 -009
(Phone) qJ)-l/ljtJ-f}/J~?
(Phone)
APPLICANT
DNEW CONSTRUCTION
FURNACE MAKE AND MODEL
LEASE COMPLETE BELOW
D REPLACEMENT D ALTERATIONS
FUEL
FLUE SIZE
TYPE OF SYSTEM
RETURN OPENINGS
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
INPUT
OUTPUT
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
FEE SCHEDULE
] % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
Industrial, Commercial & Multi-Family
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
Building Permit #
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 3C;-~~
$ .50
$ t(!J (-------
'lffice Use Only)
j'his Application Becomes Your Building Permit When Approved
Buildin!! Official
Date
Paid
Date
~
~ I&~to
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372