HomeMy WebLinkAboutHeating Permit 09-0694
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CITY OF PRIOR LAKE
HEA TING/ AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~~~w ~l~icanl I PERMIT NO. CJ9. Off; q.4-
er~s;~~~'~;-~
ZONING (office use)
Lx\.
Nb
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNE~ _ .
(Name)n~ U~\'SC)n
,
(Address) I
(Phone) Q'5 2 - L{ YO -3 (082
APPLICANT
(Name1:Jb\-t...J (-'O~~ (1-
(Address) U.rP 0 L') t ~ f\ c.k\~ f\J L f\..) t8- \ [) 0
(Address)
(Phone) -=tlD~- 3. ~~- ~S \ t)
rv~ ~ CS SLJ~1-
(City) (Zip Code)
(Contact Person) \S.R ~ Q
APPLICANT SIGNATURE ~l <==---_ .
(Phone) -=t (.D~ - :<l'S ~ - ~;S \ :::J
DATE q - \ - O~
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION PLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL\'( (J.->f"\J2 \\) \-\ 1- ~()"3D fV1, \13 FUEL Nl~. be..... ~ .
FLUE SIZE RETURN OPENINGS INPUT <60, ex. "'0 OUTPUT -=:J ( (J I rob
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
DGravity
~echanical
DAir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial. Commercial & Multi-Family
FEE SCHEDULE
I % 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 $ 400D. aU
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$-~8j. .s o. +'/.Sl)
$ .50
$ J.()~ ~ [) .5{). 0 0
Date
pai~. (/0
Date~ IS:O
No. seq 14--
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245