HomeMy WebLinkAboutHeating 03-1011
CITY OF PRIOR LAKE
REA TING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
7. 25.(l]
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3. Yellow
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
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APPLICANT SIGNATURE
DATE
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DNEW CONSTRUCTION o REPLACEMENT o ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants o Steam PLEASE NOTE:
OGravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
DAir Conditioning o Special Devices Required Side Yard
OVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL
PLlCANT PLEASE COMPLETE BELOW
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
$39.50
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $ 2L ODD ~
,
Building Permit # cJ3 .-101/
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 2zo,oo
$ .50
$ 220.50
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(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 5zJ
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24 hour notice for all inspectinns (952) 447.9850, fax (952) 447.4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
Receipt No.
4--!71(}{)
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.H..tOlg """"acto< METRO AIR
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Pounds
Q!!!. !1m! Pressure
-Gas Une
Pressurized
Inspected
.Percent CO2
PERFORMANCE TEST
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c"q..,O
(')'"7..0
I'2..Y'~
.Percent CO
"Percent 02
.Stack Temp.
finallnspettion
Date
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