HomeMy WebLinkAboutHeating Permit 09-0889 - 4714 Tower Street �,r -�- � � y j�-c� ,
o � pR CITY OF PRIOR LAKE Date Rec'd
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HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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�INNESO`��` �. P�� F�le pERMIT NO. /�'
Z. G�en �ity V V(/
3. Yellow Applicant
lease or ' t and si at bottom
ADDRESS ZONING (otT'ice use)
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`'�/ " �' <,�UG �' �S • .��' �
LEGAL DESCRIPTION (oflCce use only)
LOT BLOCK ADDITION PID
�aWNER � d1'� O�l G�� (Phone) 7�� ��� (9�� /
(Address) � L(f'L �/' c� �' �i ^. �i% dy� �C� � �
APPLICANT / �/
(Name) � (Phone) � �! � 2'�`''
(Address) D � � C�- h� � ' � % � ���
(Address) (City) (Zip Code
(Contact Person) �~w' � �' hone) / � �
APPLICANT SIGNATURE DATE .� 0
APPLICANT PL E COMPLETE BELOW
�NEW CONSTRUCTION REPLACEMENT ❑ ALTERATIONS
FURNACE MAK c A D MODEL �dYY% v!� . .��' � � O� D�� _ FUEL �LJ� I
FLUE SIZE � e `' RETURN OPENINGS INPUT (�y���''j OUTPUT �� �
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
arm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
Gravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiarion
❑Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
[]Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit. �
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi-Family 1% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ Building Permit #
HEATING PERMIT FEE $ " �
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ �"�
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid Re eip ��
Date By
Buildin2 Official Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372