Loading...
HomeMy WebLinkAboutFireplace 13.1333 5 0 O* 0 000000 X 0> & Q § n g 0 0 0 � kk � kk $ � / 73 k § § m K�k�k� § § / , \ � � -1 rn 0 � - � Z k z z z Sw I �' z / it z 0 x 1. z ¥ m 2 r 7 r o i X 'n '0 % 0 0 0 m 000000 x 41 m F PI a V■ ■� 0 -1 Z ° . 0 c 2�� � § § m ƒ . zd&x x Z m 0 0 o / Z r - n o p3 J a z § x 1117 § m k 0 = A k gl M 0 c 0D0 , § z 7 �n E % © /- "0II *0xi ni FT, k > m m \§ § m ■�. r § kr 0 d ~ C Os PRlp, 9 CITY OF PRIOR LAKE Date Rec'd HEATING /AIR CONDITIONING/FIREPLACE PERMIT f Ariv E 5 2. 1. PGreen ink F /v e PERMIT NO. / , 133 C 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS — ZONING (office /94 4 C3-),-)bk A\J use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER \) ,►�� 1 - (Name) ` 1 L, I e �1 p �1 O` (Phone) Q /Z ' 3 (e (0" 71 I l L i fid (Address) L ` c Lf t I 61 . - 6 ) - 0 4u = e (s �-" APPLICANT HEARTH & HOME Ti- wHNOLOGIES (Name) dba FIRESIDE HEARTH & HOME (Phone) Lic BC662656 (Address) 2700 FAiRVt :w AVENUE N ROSFVI11 F, MN 55113 VE15ritB33.2561 (City) (Zip Code) (Contact Person) A . I . / �& (Phone) `� _ APPLICANT SIGNATURE , -' DATE 37 / APPLICANT PLEASE COMPLETE BELOW :NEW CONSTRUCTION ❑ REPLACEMENT EkALTERATIONS 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 DAir Conditioning ❑ Special Devices Required Side Yard [Went. System gyp® oL ❑ Other Devices Setbacks FIREPLACE MAKE AND MODEL $ �I/ /�),1 - 3D 3 o) A 5 FEE SCHEDULE C N Industrial, Commercial & Multi Family 1% of job cost Residential, Gas Fireplace 17 4 / $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 # HEATING PERMIT FEE $ STATE SURCHARGE $ .B TOTAL PERMIT FEE $ 91. (Office Use Only) This Application Becomes Your Building Permit When Approved Paid J - 4 sv Receipt No. 70 , Date /4618 By " Buildinz Official Date �l 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245