HomeMy WebLinkAboutBuilding Permit 09-0046
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
2,10.0;
~. ~~~w ~J~icant I PERMIT NO.Of. oo4{p I
5'5 D 5
1'5 ()"1'" ~-t s.p
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID
OWNER . ~
(Name) B\ \ \ ,-
(Address) Ss D '0
PCt.lA.l CL B u.1 +-fl\~
15D~ S'+- Sc
(Phone) <1~;Z- ~ '11- 91 b l{
APPLICANT 0_ L I I -L. I
(Name) TT 0 1"\j1:) n..e..P..-TJ:J ,- A- c...
(Address) rJ c> { 'AJa.-S h l"'1 bi""h fi !tv.L S
(A~
(Contact Person) \J\Jl1ltJ. ~d.lW\ eL
V
APPLICANT SIGNATURE A/. ~.. U-...
(Phone) 9SZ - 8~..., III
EoU f\ D-- SS \{s <=}
(City) (Zip Code)
Cfsz. 8~s - 7/"/ J
",110 ( ()~
(Phone)
DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION Ji{r REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL BYjOJ1f 35"SCA"o~ 2-CE, 6 FUEL b~S
FLUE SIZE RETURN OPENINGS INPUTf:>O~ DOO OUTPUT -; k. l) 6 0
,
TYPE OF SYSTEM
~arm Air Plants
DGravity
D Mechanical
~Air Conditioning
DVent. System
HEATING OR POWER PLANT
D Steam
D Hot Water
D Radiation
D Special Devices
D 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
$49.50 minimum
$149.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$49.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$49.50
$49.50
Estimated Cost $ 't I 0 D . 0 0
Building Penn it #
(Office Use Only)
This Application Becomes Your Building Permit When Approved
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
1 9. S' ~
.50
)0.00
7-
Paid 50 . W
Dat2 ~ (I. 0
Receipt No. .5"7 Z3 S-
By
Buildine Official
e,
Date