HomeMy WebLinkAboutHeating 06-0270
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONTNf;/FTUEPLACE PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER
Date Rec'd
. Pink
Green
Yellow
File
City
Applicant
I PERMIT NO. tJ~- 6Y?r
ZONING (office use)
LEGAL DESCRIPTION (office use only)
'g -10 3
LOT BLOCK I ADDITION
PI
'5"- DOl ~ /0 I I
OWNER
(Name)
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(Address)
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(Phone) t/,,). - ~() - c.; fi{'i'
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APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
DATE
APPLICANT SIGNATURE
APPLICA PLEASE COMPLETE BELOW
DNEW CONSTRUCTION EPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL ??~_ ~O% ,(-z.... ~'p\."-VJ -1 A-/l) FUEL ~t$
FLUE SIZE RETURN OPENINGS INPUT OUT/uT
TYPE OF SYSTEM HEATING OR POWER PLANT
lSllWa~ Air Plants
O'Gravlty
~echanical
j\ir Conditioning
Vent. System
D Steam
D Hot Water
D Radiation
D Special Devices
D 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
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$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 #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
~Cfc 50
1ft. .50
V,-
"flee Use Only)
Buildin!! Official
Date
fhis Application Becomes Your Building Permit When Approved Paid
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372