HomeMy WebLinkAboutHeating 07-0156
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
3./901
~. ~:~~;w ~l~icant I PERMIT NO. 07. 0 l5 Ctt
/j~fo{P
j/; k.. ~~a, J ;v: E.
ZONING (office
use)
ADDRESS
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDL~, Cfz3 .003 ()
OWNER
(Name)
lJa. t/e...
8q cleo
(Address)
/ 33t;,c-
(Phone) 9Sl.- 'Ivs-- V3SJ
#~ e.
APPLICANT
(Name)
(Phone)
(Address)
'..'
12253 NIcOIIIt AYIftUI Soua ',,',' t
&;55331.
TI . a~"5200 "
152-741-1202
/C~ ;-/o.e ~(i~ "
(City)
(Zip Code)
.PPLICANT SIGNATURE
(Phone) <f S L- 7 Y b - S "o~
DATE 3/1 '( /~ 7
APPLICANT PLEASE COMPLETE BELOW
~L
'Contact Person)
DNEW CONSTRUCTION ffREPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL g~Q-'L,L .$ 55" d WD '1l..o 8 " FUEL ~; .,.c,., <-
..
FLUE SIZE RETURN OPENINGS INPUT :r 6. <.J~~ OUTPUT 7"1. ~".;)
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants o Steam PLEASE NOTE:
DGravity o Hot Water Air Conditioner Units
,..-B'Mechanical o Radiation Cannot Encroach into
DAir Conditioning o Special Devices Required Side Yard
DVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99,50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
$39.50
$39,50
Estimated Cost $
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$ .3 9. 0
$ .50
$ Y<I.~
"ffice Use Only)
Date
Paid ~O .0 U
Date.3 'l.-- 3>. 0
fhis Application Becomes Your Building Permit When Approved
Duildin\! Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245