HomeMy WebLinkAboutHeating 06-0264
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. $~~~;w ~l~icant I PERMIT NO. Q~' ~. ~I(
ZONING (office
use)
y [)7
LL'6-b...J/5 t:d ~ \;-- W f
LEGAL D~CRIPTION (office use only)
LOT ~LOCK ADDITION" /))
cVvl cn.--J
PIDe....-
~-1/9,O~/-
OWNER ,)
(Name) l.....dCl n,
qS~ ~ ?"23-Y4 qLf
c\ CL~- \'\ -f-
(Phone)
(Address)
~~~~A0lJ~ \,Y?:l Cc.,('(i(Ib'i'I{'<")
(Phone) q P):L - '2 '5L\ - ,3 <60 ()
(Address)
-----~
~C> E ~O+\.r\ d{-
(Address)
t\J S 5Lf2.0
(Zip Code)
Contact Person)
(Phone)
DATE
T PLEASE COMPLETE BELOW
APPLICANT SIGNATURE
DNEW CONSTRUCTION o REPLACEMENT pq AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWann Air Plants o Steam PLEASE NOTE:
DGravity o Hot Water Air Conditioner Units
o Mechanical o Radiation , , Cannot Encroach into
fidAir Conditioning o Special Devices Requiied Side Yard
DVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $ YnCOC~?
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$ 3C\ ,~.)0
$ .50
$ t--( (~G
'Office llse Only)
Date
9~
This Application Becomes Your Building Permit When Approved
Buildine Official
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245