HomeMy WebLinkAboutHeating 08-0435
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec' d
~. ~;~:n ~~:~) I PERMIT NO. ~ _ A,? C-I
3. Yellov..' Applicant ~
ADDRESS ZONING (office use)
W"ld-qI1~J~ 'j2/. 'e']L(J 11.J~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
flbby ,S~C~
I fJL/~ WI'ldV'1eJJ ?-id5~ '2/J /l/~
(Phone) 6101....85'0- Icf7~/
(Address)
APPLICANT
(Name) t4 d-~ I-le'-/l1.5
(Address) J600J C)cPJif'J
?:)dreSS)
C. ,I''/' ,
C/l,,( /1 (v
t4t/ e t=/ J
(Phone) 9, \a - f(<nf - ;I J j)
Lc-.tCVI '(/<- ('1~)Jo'-lLI
(City) (Zip Code)
(Phone) 9 rdi - &1 ~-- J,;))/
DATE 7-J-cJ-
(Contact Person)
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION EPLACEMENT D ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
TYPE OF SYSTEM
RETURN OPENINGS
INPUT
OUTPUT
DWarm Air Plants
DGravity
D }1echanical
&"Air Conditioning
DVent. System
HEATING OR POWER PLANT
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
FI~E SCHEDULE
I % of job cost Residential, Gas Fireplace
$49.50 minimum
$149.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$49.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
$49.50
$49.50
Estimated Cost $
Building Permit #
....
HEA TlNG PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$
$
$
L,~. ("
.50
~. c(..
Paid
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372