HomeMy WebLinkAboutHeating Permit 01-0335
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CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT t/ -c?tJ -0 J
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1..
~. ~::n ~:~y I PERMIT NO./>V- ()33 t<l
1 Yellow Applicant . - (/) ::::::J
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDvI 5" -
I &=e~R ~ i ~ ~ /1' il q( ~ ~v ~ ~~o ) (Phone)
(Address) ~ ) _ ~_ _ _ _~ __ _ /V}{J / <)
r
APPLICANT [) O/i), r I l-L:f,. '" '). 01 c'" -'4 I /
(Name) ~ 1\ l\ " ~ IJ:j r ; (~. 1\ \fOFI\n" u~ (Phone) J ~ ;Z ..... 8' 90 -.j b '6
(Address) I ~S5r1 0 ~wWVf S S-'" v~ 0e -SSJJg
(Addre.,<is) (Cit:d (Zip Code)
o
(Contact Person)
(Phone)
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION REPLACEMENT 0 AL TERA nONS A.. I ()
FURNACE MAKE AND MODEL LC:f]l\p Lcr,A OAO FUEL ''''. "
FLUE SIZE RETURN OPENINGS INPUT / 5 0) aVO OUTPUT I ~) ) )(}
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants
OGravity
o Mechanical
)g(\ir 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
"
Estimated Cost $
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
,0.0
..r 000, Building Permit #
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
_-50, ~
.50
./5fJ,5D
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245