HomeMy WebLinkAboutHEATING 07-1102
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CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONING/FIREPLACE PERMIT
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Date Rec9d
I Pink
2. Green
3. Yellow
File
City
Applicant
I PERMIT NOO 1-( I()2-
(Please type or print and sign at bottom)
ADDRESS
L(5tO LuQ.-iQ ~ ~ I
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ZONING (offIce
use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) _
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(Phone) 9\1-7cJ> - 7'1~ /
(Address)
L{~LAJ LO~) Sl. ~,c.
AP Fireside Hearth & Home
(N 20802 Kensington Blvd
(A( Attn Danlelle Ostgard 9529856675
License # 20512060
- Lakeville, Mn 55044
(Phone)
(City)
(Zip Code)
- fJ dAJ A (Phone)
C(A 71V/;U~ DATE 111((..;1
/{\PPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
(Contact Person)
APPLICANT SIGNATURE
DWarm Air Plants
CJGravity
o Mechanical
ClAir Conditioning
C]Vent. System
o Steanl
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
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FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39,50 minimum
$99,50
$64,50
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
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Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
Building Permit #
$ J'1. jQ
$ .50
$ L{.)JI
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comes Your Building Permit;\'hen ~proved Paid 1'f<0 r -
" {f (''>/07 I Date "/ !
inl!~i~ \ IDate. , II {<; o~
~tice for all inspections (952) 447-9850, fax (952) 447-4245
Receipt NO,9S'c.> S I
By ('LA 6t