HomeMy WebLinkAboutHeating Permit 09-0648
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CITY OF PRIOR LAKE If'iSO 161J::-~
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~-- cf(.
PERMIT NO. Or. ()(P+8
1. Pink File
2. Green City
3. Yellow Applicant
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
APPLICANT PL
DNEW CONSTRUCTION
FURNACE MAKE AND MODEL ~. y y IVV .
FLUE SIZE J f I" L RETURN OPENINGS INPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
f/
~./!t--r .so ~
'l- W &;v }JJ:--~
(Phone)
OWNER
(Name)
(Address)
APPLICANT
(Name)
(Address) 7 1-0
(Contact Person)
(Phone)
APPLICANT SIGNATURE
A COMPLETE BELOW
REPLACEMENT 0 AL TERA TIONS
FUEL J/IL f ta-S (
~ OUTPUT~57~'
~Warm Air Plants
DGravity
o Mechanical
OAir Conditioning
OVent. 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
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Industrial, Commercial & Multi-Family
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ t../q,so
$ .50
$ cTJO. &0'
Date
Paid 50, (/\J
Date q.. VIt JO
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Duildin!! Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372