HomeMy WebLinkAboutHeating 06-0137
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER IO-Ob
Date Rec'd
..3 . (p. U(P
File
City
Applicant
\ PERMIT NO.O& .0/371
ZONING (office use)
.3/71
If r/ 77E/CAt./(/1
c"1/C-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID Z s-
IOWNER
(Name)
(Address)
(Phone)
APPLICANT
(Name) C;;G7v~J /5
(Phone)
4.47. 37f#7
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
APPLlOANT SIGNATURE
DATE
3 (p . ~b
ND MODEL
PPLICANT PLEASE COMPLETE BELOW
RucnON D REPLACEMENT D AL TERA nONS
FUEL
FLUE SIZE
TYPE OF SYSTEM
RETURN OPENINGS
INPUT
OUTPUT
HEATING OR POWER PLANT
DWarm Air Plants
DGravity
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
Estimated Cost $
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Building Permit # ot. 01 J 7
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
elice Use Only)
Date
Paid 4-~. 0 U
Date 3. ~. () f..o
Receipt No. Sf /4-tJ
By
fhis Application Becomes Your Building Permit When Approved
Buildin!! Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372