HomeMy WebLinkAboutHEATING 07-0175
CITY OF PRIOR LAKE
HI:A TING/AIR CONDITIONING/FIREPLACE PERMIT
(Ll~ +k h'l,
~/l(Jo6
Date Rec'd
3. ]'0,01
case type or print and sign at bottom)
ADDRESS 374-8 JE-Prt;:JGS
I. Pink
2. Green
3. Yellow
File
City
Applicant
PERMIT NO. 070/75
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
APPLICANT /) ~I V- -, .I) < .
(Name) ~~/~ p/U;J2!ACt? '(jt?OjJ.J
(Address) 3 (;J.. g tv R d t- ~ witt... J 3
(Address) f
(Contact pen;on)f(A-h ~ ~ . /1
APPLICANT SIGNATURE~''''l ~ ~
..-- ~ .,
APPLICANT PLEASE COMPLETE BELOW
D1\EW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TrONS
. JRNACE MAKE AND MODEL FUEL
(Phone) is";] -,17i? - 7 Z V ~
i1."/dA/5~tU fl4tf./ 55 '3 ] 7
- - .' (City)' (Zip Code)
(Phone)
DATE
3- 3~07
FLUE SIZE
TYPE OF SYSTEM
RETURN OPENINGS
INPUT
OUTPUT
HEATING OR POWER PLANT
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
)fu1PLACE MAKE AND MODEL
i v
o Steam
o Hot Water
o Radiation
o Special Devices
o 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.
Industria], Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
39.50
.50
+0.00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Build!n!! Official
Date
Paid qt). G U
Date -, ] 0 d .7.
). -
Reci~tNo. 532-&S-
I By/[_
tJ
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
]6200 Eagle Creek Avenue, Prior Lake, MN 55372