HomeMy WebLinkAboutHEATING 07-1145
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
t ~i~~onw JJ~icant I PERMIT NO. ()? / /4-'sj
ADDRESS
ZONING (office use)
5_' .c:
, .- ;e::-.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER \ J.
(Name) ~:z
(Address) /'l/.:1-o ~ ,d . r- 0/-. S t:-
APPLICANT/? " '-/VJ _ -1-_ . -
(Name) UUA- ~~ ~
(Address) , t;~ /~ /~j -Ii. 5?S 4.J
(Address)
_ (Phooe)9~ - -: -,(.;1 73
~t.;;;r~ '-:MAJ -53
(Phone) 9~ ...~/ -- 593..,,)-
~ ~f-. fv1,J 55/.;J. </
(Ci~) (Zip Cod-e)
(Phone)~~ - ~/- f1'3~
" .
DATE // 9 0
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION IN REPLACEMENT
FURNACE MAKE AND MODEL A't{~ b(ll2t. -06 e::/lA~-;;
A'I,
FLUE SIZE ~ RETURN OPENINGS INPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
D AL TERA TIONS
FUEL 'Tta.:I.4a4
tJ,(j'Jt)t)() OUTPUT s7( oe;(}
, "
DWarm Air Plants
DGravity
00 Mechanical
DAir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Device:tu~
IiY 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.
FIREPLACE MAKE AND MODEL
Industrial, 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
v
. ~
Estimated Cost $ -2 c;:::J CJ " ,
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
..3q, S t)
.ytJ ~
.50
lice Use Only)
BuUdin!! Official
Date
Paid 1-0, (/il
Date /1_ Vj, () 7
ipt No. S5U 7S"
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372