HomeMy WebLinkAboutHeating Permit 09-1051
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
12. ~Z.01
1. Pink
2. Green
3. Yellow
~l~icant I PERMIT NO, 09 /05/1
CG\~ ~~l-vo (J ~ ~~ ~ L
ZONlNG (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
(Address)
(\\ t~~
\ ~ ~d\.\
s '" ~ ~...- (Phone) q r ~ ~ ~ \i r - ~ J8
WOO~ L~~ 1\)(
OWNER
(Name)
APPLI~l l\: \ ~
(Name) "\y"v '"'\ f' \ Y'\l
(Address) \ \9 '\ ~ \) \J ,,\ W~ !\V'L
(Address)
(ContactP=on) N t.,~ ~.
APPLICANT SIGNATURE
(Phone) q S ~-~ \.\ J ~\ ~ \.t
Or\ ~ lJ~ S-~ ~ IJ
(City) (Zip Code) ,
(Phone) ~ S- ~ - "" '"' ') ..-1 ~lJ
DATE \ ~- ~,- '1
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL (':) r \/ l-\,-\. "> 5S Lf\v <J\.\~ - G~ G FUEL N ~ +
FLUE SIZE .p V ~ RETURN ~PENINGS INPUT t.o<:J, ~~ OUTPUT $' lo. ()GJ
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
OVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
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.
FIREPLACE MAKE AND MODEL
Estimated Cost $
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$49.50 minimum
$149.50
$64.50
)~~~~
$49.50
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$49.50
$49.50
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ '1 ~ S~
$ $ .50
$ 0 ~/
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid 50 .00
Dat
iPtN05~3 (2.
Duildin!! Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-42
4646 Dakota Street S.E., Prior Lake, Minnesota 55372