HomeMy WebLinkAboutHEATING 07-1183
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~;e~n ~~!~y [ PERMIT NO.
3. Yellow Applicant ,
/' {{~J
ADDRESS
ZONING (office use)
l1':,\0
lA)60d V\e~ Ct S.t..
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Address)
p CA. L\. l
13(0
(Phone) LD l J. ~ loUD - '7 3,:)0
APPLICANT
(Name) CJ2 ual L t,
(Address) l d- 0\ \ a..
\-\ e..o~* l '" 0. ~ A ~ r C:::;er \lICK::) L" C.
I
U e V\.. +<-\.f"CL (: () u. c -+-
(Address)
S~\<ofee
(City)
(Phone) G> , ~. 8 '{ s- 3 Y l 0
q S-J. ~ V D "3" 1 \ \ 0
.~5"3 79
(Zip Code)
(Contact Person)
DATE
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
EW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODELfk<m i' / ~r, J/tJrfJ t' fl'c>-&iJ c'~ - td G /{ {SA H 0 f FUEL jJ o.../-u rJ
FLUE SIZE RETURN OPENINGS INPUT .LIS' 000 OUTPUT
"
DWarm Air Plants
DGravity
D Mechanical
DAir Conditioning
DVent System
HEATING OR POWER PLANT
D Steam
D Hot Water
o Radiation
D Special Devices
Erbther Devices Gc-'{r-o.:; e 1-1 eCL ft> r
,~'Js.+c< 1141-: c., {)., h~
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.
TYPE OF SYSTEM
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 & Ale (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39,50
Estimated Cost $ S.:S' CJ . vO
Building Permit #
7-(IK5>
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
39.50
.50
?"D . tro
(Office Use Only)
Il-lbQ)
Date
Paid 4cA/ Receipt No. SJl06
0-
Date IL--L.~-n BY~
mes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
161:06 Ed)Slc C'::BI: ^"IlR\l8, Pr;Qr T ~kp MN 55372