HomeMy WebLinkAboutHeating Permit 09-0384
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec' d
(g ./ftJ -01
~. ~i~:n ~~i;y I PERMIT NO. rtn, Q? a ~ I
3. Yellow Applicant . \../"'7. U ()~
ADDRESS ZONING (office use)
e Sf-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
fDr-\wcr-:cl
S'<C-
(Phone) CDi.- Lt lIl... C1tOlCJ
APPLIC~ k- ~
(Name) it 1 ('f\,-U \ .' .q- AS-
(Add,e")~ W 3\1\ Ik 1>~ '4 I dO
(Address)
(ContactPetSon) 6 ro~
APPLICANT SIGNATURE m. ~~0Jl
(Phone)QS2 ~ &elL(-()()(:)5
111 w ru\Jt J Ie SS33i
(City) (Zip Code)
DATE
DNEW CONSTRUCTION rn,REPLACEMENT o ALTERATIONS
FURNACE MAKE AND MODEL~~+ ~~...IAVO~lO~O FUELt"O:-4 C{\/J
FLUE SIZE RETURN OPENINGS INPUT ~tCCb OUTPUT~l(Yn
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
DWarm Air Plants o Steam Units and Fireplaces Cannot Encroach
OGravity o Hot Water into Required Side Yard Setbacks.
~ Mechanical o Radiation
Air Conditioning o Special Devices Fireplaces with Box Additions or
OVent. System o Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
APPLICANT PLEASE COMPLETE BELOW
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$49.50 minimum
$149.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$49.50
~"
$49.50
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEA TING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$ l\Ct ~
$ .50
$ ~S><lY)
(Office Use Only)
Buildin!! Official
Date
Paid50. 00
Date&. II,. ()
By
This Application Becomes Your Building Permit When Approved
o. selBe;
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372