HomeMy WebLinkAboutHEATING (A/C) 06-0345
CITY OF PRIOR LAKE
HE:ATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
514.o(p
; ~e:n ~:~y PERMIT NO. 61- . 02-1L'""
) Yellow Applicant W '../'r':::;
(Please type or print and si.~ at bottom)
ADDRESS
6f.e 20 Jil r- ~,\)J VI ~ It. '1falO, 5 G
ZONING (office use)
LEGAL DESCRIPTION (office use only)
I LOT
BLOCK
ADDITION
PID ZS-, () 3 J. (J I( , ()
~':~R ~L!- Shaw
(AddreSs)6(c(fC) ~u /).W~
~~:;~~ANT fi,r 111Ll~ ) n G. (Phone) q52 l131-bq(~9-- .
(AddressL7)W~ t~tS--. /}J #!CJ ~tJlL~ J ,MJ}56W'-L
(Address) ~) { (Zip Code)
(Contact Person) J2dM~d II ~ (Phone) ~ ()~ f1;ttJ (,R~
A.PPLICANTSIGNATUREVAlLililX (. DATE J..j -~~ (p
APPLICANT PLC~ASE COMPLETE BELOW
. []NEW CONSTRUCTION .. . PLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL{l~r - St' ('.I -Pc- ,- OtJV -I 0 . FUEL k)at-.. f4-aS
FLUE SIZE RETURN OPENINGS INPUT OUTPUT IJ;r)/JOa
(Phone)q~4lf7 - ?f4'1f'
Rhor-t ~ rcu1, 5 :t,
TYPE OF SYSTEM
HEATING OR POWER PLANT
DWarm Air Plants
DGravity
o Mechanical
... ~ir Conditioning
.I JVt:nt. System
o Steam
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
Residential, Heating & Ale (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 $ t.-l.tJ0o~
Building Permit #
HEATING PERMIT FEE $ J/: ~
STATE SURCHARGE $ ..-.,.-.~
TOTAL PERMIT FEE $ r. jt-../Q. j II ro ~
lice llse Only) ~- - ----
Chis Application Becomes Your Building Permit When Approved Paid 4-0. 0 0 Recejt No. 512.83
Date ,Date S-. L,.{) I ~0
Building Official . T l.o
24 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372