HomeMy WebLinkAboutHEATING 06-0839
Date Rec'd
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y~
CITY OF PRIOR LAKE
T-1]; A 'T'Tl',u-; I..T' ",'::'P- --~IONING/FIREPLACE PERMIT
FIIJE CLOSED DlJE
TO INACTIVITY
Sent Letter
JULY 10, 2008
(please type or pI
. ADDRESS
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R~
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BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
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(Address) / (eI 7 /'.. ~ D,,,~\ '\ u RJ.
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tj,lLJ~ . t3;DOX ~I-
. (Address)
(Contact Person) D (::..o--r) ,A r~ '^ c ~ ~
APPLICANT SIGNATURE ;: t A ......."Ia o~_v
\ - ~--r--- I '
OWNER \ ..
(Name) _Y\A.\ \ ~
APPLlCAN;fj ..
(Name) r" \ 6.~-
(Address) B\.C::8..J
r. IS, 0(,
I. Pink
2. Green
3. Yellow
File
City
Applicant
PERMIT NO. 0(,. 0839
J
ZONING (office use)
If!,lf.o
PIDZS.Of7. 055. 0
(Phone)
(Phone) q~;J-- L.J '17 ~R lJ D
frlnr&kr- ,-'1~ ~ J)
(City) (Zip Code)
(Phone) ~SJ:- 447~ <i< J J D
DATE >' -/,-C:;-DCc,
APPLICANT PLEASE COMPLETE BELOW
[]NEW CONSTRUCTION ~LACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
TYPE OF SYSTEM
~rm Air Plants
15G~vity
o Mechanical
DAir Conditioning
DVent. System
RETURN OPENINGS
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
INPUT
OUTPUT
PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
Fireplaces with Box Additions or
Cantilevers to the Outside of Buildings
Require a Building Permit.
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial & Multi-Family
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
'')ffice Use Only)
$39.50
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
l'his Application Becomes Your Building Permit When Approved
Buildinl! Official
Date
$ 39.S0
$ .50
$ +O.(J 0
Paid 4-0.00
Date q I - J_
, ~. Ow
Receipt No. 5Z,~flS
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//.
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372