HomeMy WebLinkAboutHEATING 07-0199
CITY OF PRIOR LAKE
HEATING/1~ CONDITIONING/FIREPLACE PERMIT
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l/{c{ot
Date Rec'd
4 II ('7
I. Pink
2. Green
3. Yellow
File
City
Applicant
PERMIT NO. 07. O(QQI
(please type or print and si~ at bottom)
ADDRESS
30$ IJIEz~Oud- (1~
ZONING (office
use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2~. 3CoO. O( l. .0
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(Phone)
(Address)
APPLICANT '.' h. -, ~
(Name) ~J/1/LJ5iL//1-f7 'ljWU--fC~t?(a,)4AJ (Phone) f5;P.-f??()-72tc-0
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(Address) <:/ . . L?' , ~ .__
3;;2.1 J (>>()Ai-~t.h./'4 /3 I...)U~A.-&/j~{~ ,$/J ,')Jr)27
(Address) I (City) t" (Zip Code)
(Contact Person) X;4!zt;- cJ/lhm A (Phone) q5~ -X?O-7;;lC/0
\PPLICANTSIGNATURE ~ DATE
./ APPLICANT PLEASE COMPLETE BELOW
DNEWCONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL ~tFf[ e /(A7SAU pt;- FUEL y~ U
FLUE SIZE 7 t.>t RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
DGravity
D Mechanical
DAir Conditioning
DVent. System
D Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL j( #'(5 >>? /11-V 'de;:??--
FEE SCHEDULE
1% of job cost Residential. Gas Fireplace
$39.50 minimum
$99.50
$64.50
. ..p
Estimated Cost $ 31 .::..----
HEATING PERMIT FEE
ST ATE SURCHARGE
TOTAL PERMIT FEE
Industrial, Commercial & Multi-Family
$39_50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Residential. Additions & Alterations
Residential. AC Only
$39.50
$39.50
Building Permit #
$
$
$
.50
'"'I f), () U
(Office Use Only)
I
This Application Becomes Your Building Permit When Approved
Buildin!! Official
Date
Paid 40,0 ()
Date4- ,( I. u1
ReceiBt No. ~;:' ,.., /) ,\
p ~) )/f-tV
By I
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
.....
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