HomeMy WebLinkAboutHeating 05-0740
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
ADDRESS
I 1 5 / L{ S VtVl r.t(.
CIV.
iAJ
LEGArESCRIPTION (office use only)
LOT BLOCK / ADDITION .
(Address)
APPLICANT
(Name)P;iIlY n '5 V \ lIe
(Address) 34::> I V\J
(Contact Person) e;c+h
APPLICANT SIGNATURE
fb-tftl Ni~r5L)n
I. Pink File
2. Green City
3. Yellow Applicant
~
Date Rec'd
(\ L ~ \ V
PERMIT NO.
ZONING (office use)
PID
(Phone) qS ~ - 44- 7 . b 5 Lfl.~
DATE
APPLICANT PLEASE COMPLETE BELOW
(Phone) q5~ - 2?q'-f~ 0005
tr
JdO P: vnSv/ \ Ie S 533
(City) (Zip Code)
(Phone) Q5,x-,gQLj-- (){)05
3 tJS
DNEW CONSTRUCTION o REPLACEMENT o AL TERA TIONS
FURNACE MAKE AND MODEL LL n no 'I-- I D r-r CC() a t..f Adt:L6N FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM REA TING OR POWER PLANT
DWarm Air Plants o Steam PLEASE NOTE:
o Gravity o Hot Water Air Conditioner Units
~echanical o Radiation Cannot Encroach into
Air Conditioning o Special Devices Required Side Yard
DVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi-Family I % of job cost Residential, Gas Fireplace $39.50
$39.50 minimum
Residential, Heating & Ale (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 # \
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
$
$
$
2/7. s ()
.50
LfiJ. DV
Paid
i/~/~
~, 5~5
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
By