HomeMy WebLinkAboutHeating (FP) 06-0903
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CITY OF PRIOR LAKE
HEA TING/ AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1- Pink
2 Green
3. Yellow
(Olip (()Cp
Jl~lCanl I PERMIT NO. 06 - 0903/
wood ~ D.-"-..
ZONING (office
use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER ~
(Name) ~a~
~<.~LiO'R l^-)~ ~ ~
PID cJ. -
o
(Phone) '1 'S.;;> - Lf yo ~I L{ 8J
(Address)
APPLICANT
(NameD 1 J:\:on.il'\ h;~:../ ~~ By f'lrr", . d-
(AddresJ?
9a) /09~ OA If>~ J...J#/CX)O
(Address) /
(Contact Person) -t. ,\:::, ~ne.Yhr.. ["'l
I- P
(Phone) ~lo3- SIlI-dSdS
APPLICANT SIGNATURE DATE
APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION 0 REPLACEMENT ~AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
CAo/Yn.i'1 L ~( 1t.tyrh) 1/ 553/ ~
-,-- Ci (Zip Code)
(Phone) rl(iJ~~ - S'70J--7;) 11...0
OWarm Air Plants
OGravity
fiayvtechanical
tTAir Conditioning
OVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Y:3s
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
(Office Use Onl)')
Estimated Cost $ lo34~
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$39.50
$39.50
Building Permit #
$ 3~, S D
$ .50
( ~d. () 0 ~
~PPlk,t;~ ":?::D::Udin~'i~ i; to"d
Buildin!! Official I Da(e
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Paid
Receipt No. S2-q ~
By