HomeMy WebLinkAboutMechanical 99-0092
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CITY OF PRIOR LAKE MC ..;
16200 Eagle Creek Av. S.E. Permit No. ;qq -Ode&-
Prior Lake, MN 55372
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
TYPE OF STRUCTURE
"'
3. Yellow . Conlraclor
Single Family" .?--- Two-Family
Commercial Industrial
Fee Schedule
Lot
Owner's Name L/~ /? /5 e C t:L- &.v / ~ y
Address /&"5&,6 ..5/?~A-e- -V-4-// _ NaS ~ e~ -'o/4/S~oB
,
Heating Contractor fte4.-C::-, '''79 CoOnS u/ C"~r- 5 _ I""? c...
I'
Address //'7 /;1' W~S C ~~-'7 SC- fi/e.~~4.-'9 vc.
,
t/.2- /'5%'- 7"'727
l Mulli-Family
Public Other
1 % of job cost ($39.50 minimum)
$99.5lL,
664.~
$39.50
$39.50
$39.50
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/ -c."a;7/
~ Remember to add the St~te Surcharge on the bottom of this application.
7-/ /Va 1rCr"io' you~~ ii.1n.wdes'12.;-~ ~~nal inspection.
Additional inspections will be billed at $35.00 each.
House Heating Test Record must be submitled with .buildinQ permi~ flUmbe( before build-
ing certificate of occupancy will be issued. .
HEAT CALCULATIQNS REQUIRED with number of supply and return openings listed per
room with CFM's per opening. New structures or additions send floor plan with supply
and return locations shown, HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-4230
I hereby apply for a mechanical s~tems permit and I acknowledge that the
information above is complete and accurate; that the work will be In conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permIt until sIgned by the BUILDING
OFFICIAL; that the work will be In accordance with the approved plan In the
case of all work which requires review and approval of plans.
_L ~/~/
~ ' ./ Date
. .. . c2L&!C/tJ
I Date
Telephone #
Furnace Make & Model ,fl/?' -eM 0~PE OF SYSTEM
r7 ~ " Warm Air Plants
Model Size /"~ c;c-o $/v/7" G" 't
.' ravl y
Mechanical
Air Conditioning "
Vent. System
Conn. Load 75 too t!r,; II
. /L . . r/
Fuel N, t..-"" Flue Size Y
Supply Openings
r
5
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Return Openings
Input 7 j;?~O
Edr.
Clm. 1(/00
Output
~o ~()()
,
Other Devices
Alterations
TYPE OF WORK
X
New Construction
Replacement
'-.
'-"
Repair Est. Comp. Date
Est. Cost $ _ ~ Yc::'o. ag Building Permit "
HEATING PERMIT FEE $_ _-( ~ ~-7'\ 39..50
STATE SURCHARGE $ .50 00
/ ~ .</0. - 2 I' 'I
TOTAL PERMIT FEES $ ~ _ _ Receipt # '7 1.- 70 cf--
Building Officel's Signature
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