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HomeMy WebLinkAboutHeating 06-0218 CITY OF PRIOR LAKE Date Rec'd HEATING/AIR CONDITIONING/FIREPLACE PERMIT REQUEST FOR FINAL INSPECTION SENT TO 'ink File I PERMIT NO'/')/ J/CY HOMEOWNER /0- oc.- ~~~:w ;~~icant V19- 0'-' 01 ( LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION OWNER (Name) (Address) APPLICANTt--.- ' , n 0 (Name) \'- \ r {L.. ,( OL (Address) I q '6 r f1 II- U Jill rIA fJ '/rJ 11 I}v ~ (Addres~ (Contact Person) APPLICANT SIGNATURE APPLICA T PL DNEW CONSTRUCTION FURNACE MAKE AND MODEL ~acxA ZONING (office use) PIDGt s=- /31- O{Jf (Phone) SA I' (Phone) DATE A ECOMPLETE BELOW REPLACEMENT 0 AL TERA TIONS FUEL FEE SCHEDULE I % of job cost Residential, Gas Fireplace $39.50 minimum $99.50 Residential, Additions & Alterations $64.50 Residential, AC Only FLUE SIZE TYPE OF SYSTEM RETURN OPENINGS HEATING OR POWER PLANT DWarm Air Plants o Gravity D Mechanical DAir Conditioning Yent. System D Steam o Hot Water D Radiation o Special Devices D Other Devices Industrial, Commercial & Multi-Family Residential, Heating & AIC (New Construction) Residential, Heating Only (New Construction) Estimated Cost $ 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. $39.50 $39.50 $39.50 Building Permit # HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE "flee Use Only) {his Application Becomes Your Building Permit When Approved Buildinl! Official Date $ $ $ 39- <)0 .50 lfO - Paid Lj 6,. Date 3 -"30- 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Avenue, Prior Lake, MN 55372