HomeMy WebLinkAboutHeating Permit 11-0481 0 g NK n 000000 0 > E
, _ c )
A o \ _ 0 0 73 m j kkk 0 0 z m z* k §
§ ' ��\ m K � \ o cn §\
Mq� 2 m ® w ® z - 0
ro- § m cn m z z z x 0
m ? q n I d e
§§ n z o `J Z • m m
\ 0 > z ,
E o 3
\ k ) 0 13 13 0 11111
0 '1 000000
® Z �mm m - o ® *■ -0
\ - 0 0 c _40 0 o -0 ��
) § K » m >°o °C) 0 m
0
•''' hi \ \ z 1 �ƒkk - Z ! /
§ f § §% g §
-n
\ } 0
. t_____6'
§ / )sDOOC=
m z > 0 ›
R. o AE �q -1 ® m
\ o > / /\§
m e r -4
) Z- ) K
a 0
O. , Rri; CITY OF PRIOR LAKE Date Rec'd
HEATING /AIR CONDITIONING /FIREPLACE PERMIT / /44 //
h
'Nrv>✓sot` 1. Pink File PERMIT NO ���JJJ
2. Green
lIo City // �e
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS / 11 ZONING (office use)
/J9 9 tY. / /.5'Jd! e C�rc Ie. MIA).
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID ' 361(1 . 0
OWNER L
(Name) C / ' a r i �S i /
IV a n cy } l 4 (Phone) 9sa – '/03 – 7 738
(Address) / '7 q a q f l S i ct e (t !' c, i , J 4, 0, Pr‘. r 1,4 / e � hi A
APPLIC T i ( ( '�
(Name) ) 1.10.1 . _ 14 ea°�i fir i V411 (' Pf , 1C!°S (Phone) 9 6 " 4 — 1/ rt.
(Address) ) a -I 19k // rG_ ( a ri OZ j n c&, / ` o,A p Aft/ ..5 377
(Address) (City) ` (Zip Code)
(Contact Person) '� C Z C - (Phone) go 3 - / 110
APPLICANT SIGNATURE 411101 ‘its , DATE C -
I
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION 1/1 ❑ ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
['Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation
flr'Conditioning ❑ Special Devices Fireplaces with Box Additions or
❑Vent. System 0 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
a
Estimated Cost $ 3 0 . 3 ' �" Building Permit #
HEATING PERMIT FEE $ - V 9, 5
STATE SURCHARGE $ S 60
TOTAL PERMIT FEE $ cy SD
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid ( 9-, Re Opt No. 6 74 q(
Date (_ . 1 4 , j By
Buildine Official Date U Y i ,
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372