HomeMy WebLinkAboutHeating Permit 09-0819
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
lo.r,Ol
1. Pink
2. Green
3. Yellow
~l~icant \ PERMIT NO. 0 ct, 0 8 t ~
ZONING (office use)
ADDRESS
'10
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name)
(Address)
(Phone)
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE 1\ D MODEL FUEL
RETURN OPENINGS INPUT OUTPUT
(Phone) 19lJ- S"08'.q ~o,b
S\\~Q.~ 5'S-3/ '1
(City) (Zip Code)
(Phone) lo l}.:. ~oB--qJq t
DATE J{)-q - 0"1
APPLICANT II n 1. _. l. ...,....,
(Name) D()~\<.()l,\ \.0 l\~r') ~(\c...
(Address) <6\l\1 \-\OI'\~OI'\. l)(\\\) ~
(Address)
(Contact Person)
APPLICANT SIGNATURE
TYPE OF SYSTEM
DWarm Air Plants
o Gravity
o Mechanical
OAir Conditioning
OVent. System
FI~KE AND MODEL
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
G,~ /f7lL-
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.
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$49.50 minimum
$149.50
$64.50
$49.50
Industrial, Commercial & Multi-Family
Residential, Additions & Alterations
Residential, AC Only
$49.50
$49.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$
$
$
(Office Use Only)
Date
Paid 5V .- l/lJ
Dat1Q. 9. 0
Rece' t o. 5'i 0 /4-
This Application Becomes Your Building Permit When Approved
Buildinl! Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372