HomeMy WebLinkAboutHeating 07-0650
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
; ~:n ~i~ I PERMIT NO. 01. 0 (P.5 01
3_ Yellow Applicant
at bottom)
ZONING (office
use)
SCAf\ +u G.:r. S E
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
,/ t) . 0 \ I . 0
OWNER
(Name) D LA. <AV\ Q.. M CAin \ 5 0 ...---
9<; 7 - y y., - 307,,<;
(Address) \ 'S 10'6' S'D...V1+ -Q.jL CA:r - 3+
(Phone)
(Address)
SEDGWICK HEATING & AIR CONDITIONING LLC .
8910 '1v'entworth Ave. So
Minneapolis. MN 55420
~ 881-9000
(Address)
(Phone)
APPLICANT
(Name)
...--.
(Contact Person)
(City)
(Phone)
c..{. b- DATE -I
EASE COMPLETE BELOW
(Zip Code)
APPLICANT SIGNATURE
/c,f(5)
DNEW CONSTRUCTION [8f REPLACEMENT D ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants o Steam PLEASE NOTE:
o Gravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
EAir Conditioning o Special Devices Required Side Yard
DVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$ 39. ":> 0
$ .50
$ '1 () n b
(Office Use Only)
Buildine: Official
Date
Paid .to .0 0
Date.7. ZA"',C{
Rec 1 No. 54- 2...5' ()
B
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245