HomeMy WebLinkAboutHEATING 06-0904
CITY OF PRIOR LAKE
HE:ATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
/o.,.~,
1. Pink File PERMIT NO 9
2. Green City . 0& _ .- 0:.A ~
3. Yellow Applicant ~
.ease type or print and si~n at bottom)
ADDRESS
ZONING (office use)
/1-2{'5
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2.S. 3 S 1. () 2.. P CJ
OWNER
:(NItme)
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1jDfflJ111N
CPhone)Vf rid -q W-fS/ i fp
(Address)
APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person) 1 I l II.. A (Phone)
"A~'PtICANTSIGNATURE /\.1LR..A ' ~~ OATE tb- (g-olp
PLICANT ~:l1 COMPLETE BELOW
[]NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
l' URNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
DWann Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
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.
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
ST A TE SURCHARGE
TOT AL PERMIT FEE
$
$
$
39. .sv
.50
4'-0. 0 0
(Office Use Only)
Buildin!! Officiall
Date
Paid 40. (,.~}
Date I (), & . (; 0
Receipt NO.5 2--I--rP S
/
By /,'
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LJ
"'his Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372