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HomeMy WebLinkAboutHeating Permit 11-1246 5 O =X 0 000000 0 > z n n o 0 3 0 �kk Z m k � � Q r q X X A 3 �r E§] k -I Pr r ) § ® m § \ d u o 2 � % R k ›- -1 m 2 6 2 2 to j d> ° \ ; k0 \ 0 § § - I m 1 i 4a. Z 2 0 0 ' % Ooec=o Z § m § m "* M� o z o o A 0 C -1 c k 2 ? m Maui $§ 73%§ m o 0 k \ m § \ 11.11. > § § § § 3 z % � m iii 0 a r n0 0 73 0 0 \ 0 \ m / \ -0 P � m / S2 0 I ] k m % ` @ % E c== 0 0 z 2 2 R. v ® Cmr § ® \ 0 §00-_ q 53 - - te r K ® z - qr d F PRIG , 'I' CITY OF PRIOR LAKE Date Rec'd N B HEATING /AIR CONDITIONING/FIREPLACE PERMIT U Q ' 1y 2. Gre 1. Pink en F Cit il e y I PERMIT NO 1 1 , ( Z 4 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS 2 /y, /�, Y ( .// 1 /` /Y� ( r- //� !/G/11 /r. ZONING (office / J 2 / ✓ / 1" / � W y C ` ` 5V--' use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) S // A J + ^ LL - (Name) v` I /L� - l�� � L � (Phone) 267 -5 -6S (Address) / 2 i Y Qii- e06 c 1` ,5 . APPLICANT p C -L,73- 33p (Name) f L (w 5 I - t , H u ' (Phone) (Address) Z) °° FA 0-010' (L AZ 0., P35 v t.-LE IM N 531 !3 (Address) (City) (Zip Code) (Contact Person) _ ) C 411 j;, i _ I (Phone) (off c9 3 e— 3 305 APPLICANT SIGNATURE •ff©�fYa DATE AP ' LICANT PLE , SE COMPLETE BELOW ❑NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT ['Warm Air Plants ❑ Steam PLEASE NOTE: ❑Gravity ❑ Hot Water Air Conditioner Units ['Mechanical ❑ Radiation Cannot Encroach into ❑Air Conditioning ❑ Special Devices Required Side Yard ❑Vent. System ❑ Other Devices Setbacks FIREPLACE MAKE AND MODEL .., tic.` -Xi 3Z , 4; - Lii FEE SCHEDULE Industrial, Commercial & Multi - Family I% of job cost Residential, Gas Fireplace $39.50 x Z $39.50 minimum Residential, Heating & A/C (New Construction) $99.50 Residential, Additions & Alterations $39.50 Residential, Heating Only (New Construction) $64.50 Residential, AC Only $39.50 Estimated Cost $ Building Per!' it # HEATING PERMIT FEE $ i 119- ro – 49--1 STATE SURCHARGE $ • ? ° i TOTAL PERMIT FEE $r— (Office Use Only) This Application Becomes Your Building Permit When Approved Paid 5 -q ., S � Rec pt No. & . 6 Date / /. (( Building Official Date ' 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245