HomeMy WebLinkAboutHeating 06-0299
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER
Date Rec'd
'f . l- ~ /r/ 6
File
n City
)w Applicant
I PERMIT NO.O~, ()Z-f f I
ZONING (office use)
LOT
BLOCK
LEGAL DESCRlPTION (office use only)
ADDITION
PID 2- ~ .'$:> 7. 0 <1-r: "
OWNE~ \ ~
(Name) CA. (j I C
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APPLICANT S I Ii tiJ G/- ti ~
(Name) 'r e-S /'C ~ t? fA ,. (J JIH (!;phone) 9' ~ .... 7 Jl ....;?/ (/J I
/t(3 Cfrz t1u11J-;J~f-oVl Ilvp Savagft,i2!JJL 55)78
(Address) (City (Zip Code)
(Address)
(Address)
(Contact Person)
q~J-~35-/3;JB
(Phone)
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APPLICANT SIGNATURE
APPLICA
NEW CONSTRUCTION
FURNACE MAKE AND MODEL
PLEASE COMPLETE BELOW
o REPLACEMENT 0 AL TERA TIONS
FUEL
FLUE SIZE
TYPE OF SYSTEM
DWarm Air Plants
DGravity
D Mechanical
DAir Conditioning
DVent. System
RETURN OPENINGS
OUTPUT
INPUT
HEATING OR POWER PLANT
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.
D Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial & Multi-Family
$39.50
$39.50
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
"fice Use Only)
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
Paid
Receipt No. ..57 L.SlP
.I'his Application Becomes Your Building Permit When Approved
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Date
Buildin!! Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372