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HomeMy WebLinkAboutHeating Permit 09. 0359 — 0 O\ n 000000 1 3 0 > 2n I § 0 cn ] 0 0 0 2§ ƒ K kk0 k m 73 k § 0 k § / 0 0 q M z� > §§/ z $ a m r n n e 2$ �n§Q P 2xj t k\ k v,\ z z § o co 23 e \ } Z F 1I ! ` \ I : 4, m 2 0 0 000000 Z m m m ■ -o® *■-o k K ° zm m}& -0 o IT) m 7 2 k/ 0 ] Z X Z m z . 1 2 2 r %00 \ § P \ § q] 0 2 4 . z z r % 2 $ m � �. r �� § / _ m 1 . 1 c o 7 . ( m 0 \oocEO ® 7 ® o } > z i' 'a2$§§ � ,2 0 , §� §$ ) \ z 7.�K0\5 \ — m 0 r >mm . ) rn r AI 11 r - 6 § r- \ • K r of -PRI CITY OF PRIOR LAKE Date Rec'd 9 HEATING /AIR CONDITIONING /FIREPLACE PERMIT / l0 33 '1 NNESe I. Pink File T NO. 2. Green City PERMIT cQ Oa/ / 3. Yellow Applicant _(Please type or print and sign at bottom) ADDRESS ZONING (office use) /5 0 3 6 oVe_ Wet LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER ..�— j � (Name) I m l G K� !/ (Phone) `P'1 2 � �T (Address) J 5 s 6, k d 6.,,,a (:f/IJ r / Ov tor. K, . t in j ,,..:s ,.✓v, APPLICANT / d (Name) e- /7 T � / yY [ C 4h. (Phone) '.S 2' / 7 / /G 7 7 (Address) 7 '/t9 e u Q -S 44 :/ ),ettre;j -.C") .3 �N"‘c / ' • ,. /J .:, (Address) (City) (Zip Code) (Contact Person) 1- P. j.- e v (Phone) y APPLICANT SIGNATURE DATE ` APPLICANT PLEASE COMPLETE BELOW ❑NEW CONSTRUCTION . p i REPLACEMENT ❑ ALTERATIONS FURNACE MAKE AND MODEL C //✓ s7 7 fr -- . > FUEL A.),9 ,: 6 FLUE SIZE 6 r ' 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 iHot Water into Required Side Yard Setbacks. El Mechanical Radiation DAir 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 $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 $ jd ©0 ' Building Permit # HEATING PERMIT FEE $ _ y9. STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ 50 (JD (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Recei No. sbszi ve) _ Date (/ 0 By Buildinir Oftici Date • 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 16200 Eagle Creek Avenue, Prior Lake, MN 55372