HomeMy WebLinkAboutHeating 06-0328
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER
Date Rec'd
~::y IPERMITNO'~01Z~1
ApplIcant
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
'3df i Oeo...vfVOt
fnl{SDtf
(Address)
(Phone) 95';)- '7''17- .:2SJ/
Jv SS:J7Z
APPLICANT
(Name)
7hol1-4. ('pc..
8839 ~f
(Address)
H~~"-i~J
)5/ 5fy~d
(Address)
(Contact Person)
APPLICANT SIGNATURE
(Phone) 9S.2- ;1:26- 4328
prid-/ A<:;k fJ'Jiv SSJ7'2
(City) (Zip Code)
(Phone) 6/2'" ;J2J.- ;J.t:;;:J Y
DATE ~->>-o6
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION EPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL ~e~,pv FC9//oBo [31?-Li P J I FUEL II/j,.T
FLUE SIZE ~/, (1JL RETURN OPENINGS INPUT Bo/lXt) OUTPUT 70-a1O
TYPE OF SYSTEM HEATING OR POWER PLANT
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
iJWarm Air Plants
DGravity
o Mechanical
DAir Conditioning C<111 ol..l ~
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
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
Estimated Cost $
Building Permit #
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
ffice Use Only)
pplication Becomes Your Building Permit When Approved
".1- ~/i /0 ~
BuUdin!! OffiCIal . date
$
$
$
_:;9. S- ()
.50
I{O.OD
Paid LI
-,O,.DO
Date5j I 0 (.;.
Receipt No. 5(27'
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372