HomeMy WebLinkAboutBldg Permit 07-758 H/AC/F
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CITY'OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
I. Pink
2. Green
3. Yellow
~:~. I PERMIT NO. 1 -7c~
Applicant ./ V
ADDRESS
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) 7H~E
(Address) f 4 Ce ~ z.
T'~""'~6
l-v (l- ~ -S ?~tc' L.vt-1
(Phone) 6 (l- Cj(P (- S....Y 5 z.
APPLICANT / I
(Name) F ~~f!: 5 c v:>iOt'-1 ~O~~S
C {('4.. L,f; L:,r-v::. (:- L ~
(Address)
(Phone)
0(1-- 2'2..(-L'LIS-
(Contact Person)
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, (City)
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0- 0 L l.
(Zip Code)
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APPLICANT SIGNATURE
(Phone)
DATE 09-10/-0 7
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
DWarm Air Plants
DGravity
D Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
D Steam
D Hot Water
D Radiation
D Special Devices
D 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.
TYPE OF SYSTEM
FIREPLACE MAKE AND MODEL
6~~oK
-;sq
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
qo.ol
Paid
Receipt No.
5'157'
Date
24 hour notice for aU inspections (952) 447-9850, fax ( 52)
16200 Eagle Creek Avenue, Prior Lake, MN 55372