HomeMy WebLinkAboutHeating 07-0732
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
LOT
BLOCK
ADDITION
i ~~~n ~:~y LPERMIT NO. O' 7. 07'? 2.1
3. Yellow Applicant ..) .
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I
ZONING (office use)
~ase type or print and sign at bottom)
I ADDRESS ./}
}1fkCo~ fVJ~ (lM~tJ
o 30.<l I
LEGAL DESCRIPTION (office use only)
I::: J[~; ~~p'l}
APPLICANT
(Name)
(Address) S €i:tS-
LJ Ji/ol
%;).. ijdl-S93;)
-
Mt1 S$"ld
(Zip Code)
(Address)
(Contact Person)
(Phone)
DATE
o
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION REPLACEMENT D AL TERA TIONS
. 0RNACE MAKE AND MODEL
FLUE SIZE
TYPE OF SYSTEM
RETURN OPENINGS INPUT
HEATING OR POWER PLANT
FUEL
OUTPUT
DWarm Air Plants
DGravity
iMechanical
Air 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 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
~Y.:?
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 3c; .:sD
$ .50
$ .1../0 LX) -i"
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
Paid 4-0. 0 ()
Date &. l.c . \., (
Re~ipt No. ~ ./LL71
.~T":::>v
BuUdin!! Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372