HomeMy WebLinkAboutHEATING 07-0065
CITY OF PRIOR LAKE
HEATINq/,{\IR,{;ONDITIONINGIFIREPLACE PERMIT
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Date Rec'd
,J:'lease type or print and sign at bottom)
ADDRESS
(jJ 5 le (j \~n { 0+Se (/ ~
~'~:~n ~~~, PERMIT NO'07 0 01 C I
3, Yellow Apphcant . V ::::..J
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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(Address) (jG(bLf r~ hi a 1,V7W rl,w
(phone)
APPLICANT
~ame) ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone) 651-633-2561
(Address) 2700 N. FAIRVIEW AVENUE
(Address)
BRENDA h'USTON
(Contact Person)
ROSEVILLE MN
(City)
(Phone) 651-633-2561
t:; t:; 111
(Zip Code)
APPLICANT SIGNATURE DATE
/ APPLICANT PLEASE COMPLETE BELOW
QNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
~ cbh- (jln TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm A Plant 0 Steam PLEASE NOTE:
L .. A j (\ . ir s Air Conditioner Units
\J\'LI..Y(;L OGravtty 0 Hot Water
, r 0 Mechanical 0 Radiation Cannot Encroach into
'~ bOO ~lb70Air Conditioning 0 Special Devices . Required Side Yard
, () D ( OVent. System (,Xl Other Devices -ft v,f J?l /l. A .fl..-./ Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEESCHEDUL ___
1% of job cost esidential, Gll!1 Fireplace )
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
~/
$39.50
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
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Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$ .50
$ l,.H) (()U
IOflice Use Only)
Building Official
Date
paiVo ~
Datz {(" (i 7
Rece1~No'E 2 t S-r
By l--~
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.Iis Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245