HomeMy WebLinkAboutH/A Permit 07-568
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
i",';
~: ~~n ~:~. I PERMIT NO. 0' 0::> Co '" I
3. Yellow Applicant ' I . U .
~lease type or print and sign at botto:m . .........'...... F" .,",
ADDRESS~f .....
?~d-q J.h 4 O'V'y ~ A/~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Address)
~
(Phone)(,/ ;},- ~O J - -n~
S-:5"372.
APPLICANT /\
(Name) (.-/6h') ~ ~r"e-;, J:;''V1L", (Phone) 95~--q'11-tblj'1
(Address) 7t1O ~ WttJJh i'vto, n:vJ Ifv.e-.- ~fWt f~"'(',e.. Mill ~?'3~l{
(A~ss) , (City) / (Zip Code)
(Contact Person) ..:r-~h. Vl 6 vL1.,J~~ (Phone) ~#95;}...--9'1I-JOIfY
APPLICANT SIGNATURE DATE ~- .;z.s- .-c:r7
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION gREPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL ?~41/' I~ S-g-- () AAo9t!J FUEL /I.ki;:;:t""', ~4~
FLUE SIZE lj tl RETURN OPENINGS INPUT ~ml'.? OUTPUT 70 O/~
TYPE OF SYSTEM HEATING OR POWER PLANT
jgWarm Air Plants
o Gravity
o Mechanical
DAir 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
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
$39.50
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $ ~7()()
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ ? q,5'tJ
$ .50
$ Lf.O . 1'10
Building Official
. (J'L)
Date1
Date'? . u
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
Paid
5ft.l
his Application Becomes Your Building Permit When Approved