HomeMy WebLinkAboutHeating Permit 09-0758
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
'I ZZ~07
Jl~iCan( I PERMIT NO'Oq, tJ7std
I. Pink
2. Green
3. Yellow
ZONING (office use)
l_ y \ 6c 'K ~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
Pill
s
(Phone) '-\ ~ ~..~'\ ~ .\IT 0
(Address)
\\ ~\r\l
, - ~ ~
~~
OWNER
(Name)
APPLICAN~ \- '
(Name) \ \.>... \ ~ t\ ~ r ~ i) "-
(Address)' ~ (\ ~ ~ \\. ~ \ '-- 0~ ~ \1'-.
(Address)
(Cootact Person) ~"'''''''-) ~ "I-, l~
APPLICANT SIGNATURE "v~ )
(Phone) ~f d-' '-\ 4l - ~ )~ ~
~ (\ 0-- \.'"'\~ s 5' 3/ ~
(City) (Zip Code)
(Phone) t\.r )." l.\ \.\ / - 8 \ ~ ~
DATE Ci - ~, - ~
APPLICANT PLEASE COMPLETE BEL
DNEW CONSTRUCTION 0 REPLACEMENT
FURNACE MAKE AND MODEL
FLUE SIZE RETURN OPENINGS INPUT
W
ALTERATIONS
FUEL
OUTPUT
TYPE OF SYSTEM
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent System
FIREPLACE MAKE AND MODEL
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
'I51tOther Devices ('~ ~C> '- {l\~
\'~'f\.,'~ ~ ~ ~\Jl.\.~~ ~ ' .
iYl '" "\{~ \.
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.
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$49.50 minimum
$149.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$49.50
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
$49.50
$49.50
Estimated Cost $
Building Permit #
$ 'v\ ~ So
$ .50
$ .)0 6J.
~
--
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
Buildin!! Official
Date
SI
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