HomeMy WebLinkAboutHeating Permit 11-1028 _ 0 0 0 0 000000 > §
n n nn� O ■�z"n 0 o SO
o»° k k k s " C E 2 § L 7 9 om @
hi r m m m$ § zv ■ 5 . co §
t >§
z m 0 zk
q & n @ _ 10 cn 0 Z z (4 § ■
b & 7 7.1
` § o,
% -n g mm
73 r § 3
k 0 0 n
❑❑0000 A
m §mm s-.■s■
O § o o . 0 -10 C
i ■■ m zs 0 0) m \ 0 ` . »0 a 0 < m
NI
0 o 0 �� § 2
§ o a CO . »cc r
z n m .. r 13 -a P §
I k .
o
0
0 ! .
■ DDX000
m L.-i -±- § f 0 1nn § O .>
° 7 r -o -o�
41 i 555
q 0 tmm1
r xi mxi Z r
•
�r 0
a. PR.794
CITY OF PRIOR LAKE Date Rec'd
N I HEATING /AIR CONDITIONING/FIREPLACE PERM
'
`\
1 Pink File PERMIT NO.
2. Ye City // /O zVVV
�
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office
5 (fib j Z 4tf / Qi ,j ) /1 - use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) 5/78 L- (Phone)
(Address)
APPLICANT .i Hoes T ea doi ss. hlc.
(Name) df & fiwwhl f (Phone)
IJMt*n MO
(Address) einisiteriAll. (Address) (City) 3 (Zip Code)
(Contact Person) 3 N a,.. 1 (Phone) lJ J/ L 3 S -- 31 J 1
�� Y L
APPLICANT SIGNATURE ��•` A gi DATE 2 �
APPLI ANT PLEASE 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
[Went. System t 1=I Other Devices Setbacks
FIREPLACE MAKE AND MODEL j ' t471t47'' - u 1 3 -i
FEE SCHEDULE
Industrial, Commercial & Multi - Family 1% of job cost Residential, Gas Fireplace $39.50
$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 Permit # i
HEATING PERMIT FEE $
STATE SURCHARGE $ .5 ► 4 / 5
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 5 S ^o eceipt No.( /'27,
Date [0 .S o1 I y
Building Official Date ,
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245