HomeMy WebLinkAboutHeating Permit 09-0820
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
/(; ,q,Oj
To~~~:tmd:too: ~
I ~ Q >.';IM. ~(\
~: ~:;w Jl~icant I PERMIT NO.()~. Gfz.) I
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name)
(Address)
(Phone)
APPLICANT \ '"
(Name) t\()('\<o" Cb(\~ckr-~ -1..V\~,
(Address) %\'\/ ~Ch<..O~ ~l'\" ~
(Address)
(Phone) to \;}..... S"'O~ -<1;) q (,
:')\A~~OQe '5'5""31 '1
(City) '" (ZIp Code)
(Phone) {Q td-.- $"'08 - q Jq t
DATE {($)-C},oj
(Contact Person)
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
TYPE OF SYSTEM
DWarm Air Plants
DGravity
D Mechanical
DAir Conditioning
DVenL System
RETURN OPENINGS
INPUT
OUTPUT
HEATING OR POWER PLANT
D Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
FIREPLA AND MODEL
/11tfi{/b I-tnz.-.
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 & AlC (New Construction)
Residential, Heating Only (New Construction)
$49.50
$49.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
4--Cr. j-V
.50
,)V /VV
(Office Use Only)
Buildinl!: Official
Date
Paid 50 . n.J
Dat10. 9 ~o
. tNo. ~()II-
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