HomeMy WebLinkAboutHeating 06-0907
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
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; ~~:n ~~:y I PERMIT' NO: ~~--nrn
3. Yellow Applicant , ~.. 7'~
I.. ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT)./ BLOCK I ADDITION
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IOWNER
(Name)
(Address)
(Phone)
~~:~~ANT Wi' AI.) 171 ~NAf ;J om l.J
(Address) /175 /~;? 6:. jj r Sill II' eil- U i"I
;'j'.(Address)
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(Contact Person) a a r ,j.'" j () 'AI' JuA'
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APPLICANT SIGNATURE - I::"-,,,(;.~~.
(Phone) (p j- I" "f v t. . /Y'o (/
f Ci Uj A ilIA
(Qity)
~/;l. - j(P 9'76/2-
/(.1'..1- () t
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(Zip Code)
(Phone)
DATE
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APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
TYPE OF SYSTEM
RETURN OPENINGS
INPUT
OUTPUT
HEATING OR POWER PLANT
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
o 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
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
1 %of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
ST ATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
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"flee Use Only)
Paid
Receipt No.
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fhis Application Becomes Your Building Permit When Approved
Date
/. /,
By
Date
Buildine Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
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