HomeMy WebLinkAboutHEATING 06-0906
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please type or print and sil!;n at bottom)
ADDRESS
/~9'~ L?f4ua-A a~ 5~
~. ~;'~n ~!~y I PERMIT NO.()/~ 010 I-I
3, Yellow Applicant f.I . ""
,
. ZONING (office
use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER .0
(Name) old.. /kkl'/
..1~/N k/ Lr
. (Phone) 't5~- -10/7- ;t.r;~v
(Address) /~~j:;1 PiA-llL,-/" 4~ 5d'
~J~1t. /nL #//'1
1~~~I~ANT76i?# ~chmv/cl# ~c.
PID
$..m-
(Phone) v/:J. - 7;z.9- 5(, yt,
(Address) /1A ,"".4
:35i?fJ ..fWV/JH; ~~ /rH~b~ .rr/d ~d-
(Address) (City) (Zip Code)
(Contact Person) ~Ju ~..eJSe>1Y . (Phone) (;/~- .:3"9- /Of('J - tJd/
APPLICANT SIGNATURE ~U- DATE .,A:;..,3-o(,
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~CEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL &~.m PJp'7 FUEL N ~
FLUE SIZE S If RETURN OPENINGS /'1'1'/ INPUT ~~ OUTPUT ~O/~YO
~ /
TYPE OF SYSTEM
HEATING OR POWER PLANT
o Steam
~
o Radiation
o Special Devices
o Other Devices
DWarm Air Plants
OGravity
[31Vfechanical
DAir Conditioning
OVent. System
FIREPLACE MAKE AND MODEL
Industrial, Commercia.l & Multi~Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
~
Estimated Cost $ ~
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$ 3~
$ .50
$ .39:S--
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid :5d),30
Date t 0 I C, . d ~
Buildinl! Onicial
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
~6
vO
,~Il~ ~O /
. Recent No. 5 ~
By I
/ _I
v