HomeMy WebLinkAboutHeating Permit 01-0712
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I. Pink File PERMIT NO
2, Green City . ,/ J
3, YeHow Applicant L.-.
~/'- (11 ~
LEGAL DESCRIPTION (office use only)
LOT d-sLOCK I
PID ,;7,)- =3
~~
OWNER
(Name)
(Phone) r s-J-J 33 - / ;? ~ r
(Address)
APPLICANT
(N ame)
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
INPUT
REA TING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OUTPUT
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
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
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39,50
$39.50
Estimated Cost $
Building Permit #
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
~q~o
.50
lie) ,c)cJ
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
Date
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245