HomeMy WebLinkAboutBldg Permit 07-692 H/AC/F
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
7.36,cJf
~: ~:n ~~~. I PERMIT NO. 01.oeoo,.1
3. Yellow Applicant ~
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LEGAL DESCRIPTION (office use only)
ZONING (office use)
LOT
BLOCK
ADDITION
PID
OWNEILr-lL
(Name) _I dl\.r~:)'b ~
(Address) 1l(Ce-] 2-- GL~t::>5
(Phone) (pr'l,-ec(gf - 6-4 )~
APPLICANT
(Name) ~~(l€:s CcJ<b~ ~f;-.J
,,"" (Address) Ll U&- C-l~e- L.k€- Lw-f!;
\ ~ . (Address)
"(Contact Person) ~
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(City)
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(Phone)
(Zip Code)
(Phone)
DATE
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
o Gravity
o Mechanical
OAir Conditioning
OVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation /'
o Special Devices &:As c-rd-
o Other Devices GA-<4~
Coo{L mP
PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
ireplaces with Box Additions or
ntilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
~?.. <)0
.50
40. -
(Office Use Only)
Buildin!! Official
Date
Paid 4-0 . uU
Da~"lO.O
P No. ~L/~YV
This Application Becomes Your Building Permit When Approved
24 hour notice for aU inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372