HomeMy WebLinkAboutHeating Permit 14-0317 - Furnance and window E c O n 000000 "a o > Eo
n n a § § . ® ��� § � H
2 §
k r 71 k 00) m z � �� c2z § co
� q a 2 -. -Q._ ®
2 t ■ » •d m 0 0
q B § q § S
"1 0 z -I z 0 x
rxi 73 r z 3 m
✓ o , . �'
- -n -0
% 2 7 0 73 § , 10000
41 mm m c � ® ■ camIsi
X $ o Q nc -1oc
§ g m 0 0
k m ƒ ¥ z„. � kz � .c x z ! ._ z
q
mi
rn@\ ■ -I � c
m § . zcc z r
Pe o § # - r- TS P m
/ i73
I m
S n
2 . � OOQOo
7 X22 § §
% o .� o / comms
3111 z
% z , � kk §
lo qm ■ � r 2
"If § m
r,
o� rRID, CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Q
4tINNES01P 1.Pink File PERMIT NO.
2.Green City / 5I/
7
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use) .
1 l % CV c\Ns )-N A vt
LEGAL DESCRIPTION(office use only)
LOT BLOCK ` ��ADDITION PID
ONaWNER meC 1`\( _ \ V�ti a K� (Phone) to\a- O-� 11, -
r
(Address) \ &' \ 9,i c: G,..., Sv U,1 A J'(/
APPLICANTS `'
(Name) �" l�(-0 V't, e- �-.�')L (Phone) q c a- "1 u l- 1 ,
(Address) \\,t,q \A \\Lv f\I C ` (' \ v `'1 N S 31
NI (Address) (City) (Zip Code)
(Contact Person) IV cv-N Ly S &V,� ‘.- (Phone)c1 S. -\it V1'?
APPLICANT SIGNATURE 'NY\ )�� DATE S -f — I T
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ,1 REPLACEMENT ❑ALTERATIONS/�
FURNACE AND MODEL lr\ c.,\ -3 I0 f1f0 O Z kAO�I 0 FUEL V
FLUE SIZE c\tiU..6 RETURN OPENINGS INPUT1 0) O Uv CI�p Co Co 0
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 0 Radiation
❑Air Conditioning 0 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 $49.50
Estimated Cost$ Ot 'pi Building Permit #
� � SG
HEATING PERMIT FEE $
STATE SURCHARGE $ S 9P
TOTAL PERMIT FEE $ S S '/
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 57/.1-0 Receipt No.71 j1 c
Date 57 /J� By dip
Building Official Date /'7'"
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 /
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372