HomeMy WebLinkAboutHeating 06-0072
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER
ll~tQ R.Q~'d
~!;y I PERMIT NO. (X, ~oo7" I
.pplicant , ~
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
J
OWNER F
(Name) . A-<<-5 +-
(Phone)
(Address)
S-~- q
~,,;~~ANT Pr f I\-k-~ 1-+ ed 1lJ' -Kro I ~hOne) It, 12 - q (7 -~ :3 (.. 7
P. D. Boy 1i LA-4<ev[lI~1 fY\tJ S;-~()Yi
(Address) (City) (Zip Code)
(Contact Person) ~ I{ 4l.l..- (Phone) l.p l 1... -q I q - 4 '3 ~ 7
Cu-t /G.-U-- DATE-6
(Address)
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 ALTERAT~
FURNACE MAKE AND MODEL ----A:JIJ ~ 4 'L. :0 u.c.:twol t f(R-'1ifi:r::
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
\
DWarm Air Plants
o Gravity
o Mechanical
~ Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
D Other Devices
PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
Fireplaces with Box Additions or
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 minimum
Residential, Heating & AIC (New Construction) $99.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
Estimated Cost $ Building Permit #
::;;~ .Ml,fJ
$3 \Nt r".
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tit ' "
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
31. S- 0
.50
~, t'/o
(Office Use Only)
'his Application Becomes Your Building Permit When Approved
~~ t!l/o<p
Buildin!! Official I bate
Paid
~tf, d1J
Receipt NO:.:;;-c;t!'9/
By
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
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