HomeMy WebLinkAboutHeating Permit 09-0050
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CITY OF PRIOR LAKE
HEA TING/ A TR CONDITIONING/FIREPLACE PERMIT
Please call for a final inspection
upon completion of work.
Date Rec'd
Z-I'2-"O I
(Please type or print and sign at bottom)
I ADDRESS
L 151tf3
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Pink
(ire'en
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AppliL"dl1\
I PERMIT NO. 0 fOOSd
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ZONING ("mc<~J
r
I LEGAL DESCRIPTION (officr"" "o(y)
LOT BLOCK ADDITION
.___ u _=J
PID
(Address)
(Phone) 9sa -44-0 - jQ'8D
\ m N 5531:J...
IOWNER
(Name)
APPLICA~lh' _: ~.~~. +h
(Name)~ ~ V'
(Address)Jro 8dh~V' I
(Address)
(Contact Person) rVliC. ,
~PPLICANT SIGNA TUItE
.:!:- Hnr:r:::e (Phone) ~-CfCl.d /9d 7 G:,
,~rcib VI VV1 f\) 5.5 5 J
I (City) (Zip Code)
(Phone) q5d-Lf1~--Cj:J-~
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DATE
I
ONE
APPLICANT PLEASE COMPLETE BELOW
ONSTRUCTION 0 REPLACEMENT ALTERATIONS
-1
FURNACE MAKE AND MODEL FUEL
-~--~------~-~._-_.~--- ~-_._------_._-------~--
FLUE SIZE
RETURN OPENINGS
INPUT
OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
DWarm Air Planls 0 Steam Units and Fireplaces Cannot Encroach
DGravity 0 Hot Water into Required Side Yard Setbacks.
o Mechanical 0 Radiation
OA. C d.t. . 0 S . I D . Fireplaces with Box Additions or
Ir on I lon1l1g pecla eVlces '" .
OVent. System 0 Other Devices CantIlevers to the Outside of BUildIngs
c FIREPLACE MAKE AND MODEL ~~-G It" S~Pf2_f:X"Ul',,;ea ~~Jdin~~er~ ... __ .._ .
FEE SCHED LE .. .._----_.~
I % of job cost Residential, Gas Fireplace _---->
$49.50 minimum
$149.50
$6450
Industrial, Commercial & Multi-Family
~
Residential, Heating & A/C (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$49.50
$49.50
Estimated Cost $
Building Permit # ___
HEA TING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$~
$ .50
$ 50.00
(Office Use Only)
Buildinl! Official
Date
Datez. rz..- ,d
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372