HomeMy WebLinkAboutHeating 08-0582
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. 6i~~n ~~i~y I PERMIT NO.O B. 05e2-1
3. Yellow Applicant
ADDRESS
ZONING (office use)
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//7 /I tL~ (tl41L,
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
OJ) An cl~
S */'h I
J ;U
Lc I ).\S r tz; r)
(Phone) tJed- V'/7 d <FbI
(Address)
APPLI~T .. 1/ " '/c-;::'
(Name)~Ll r I7S t..J , /1..., !i~ll...-i-",1.S 't ;(, ~ ~lC
(Address)~yS-1 W l8u. F/1Si/ '// K t:f:>o
c--. (Address)
~u.f C{~1
(Contact Person)
(Phone) q 5 d- cfq y.. OCJos;,-
~lll-nJU : If. 6-~33.
(City) (Zip Code)
APPLICANT SIGNATURE
(Phone)
DATE
APPLICANT PLE SE COMPLETE BELOW
DNEW CONSTRUCTION REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL VO,,- k ?(! q 81 a IV (J~tJ u PI ) FUEL /1/ C A1'
FLUE SIZE R~URN OPENINGS INPU~ OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
DWarm Air Plants
DGravity
~Mechanical
~Air Conditioning
DVent. System
D Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
PLEASE NOTE: Air Conditioner
V nits 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
!2.{tktL-<<- (~~ ~ A}:!...
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
(JI' h
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$49.50 minimum
$149.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$49.50
$49.50
$49.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ c..JC; .aJ
$ .50
$ -57'J - tJ{)
(Office Use Only)
Date
Paid 50 ( (/l)
Date &. ". 0 &
This Application Becomes Your Building Permit When Approved
o~3tf--
Buildinl! Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372