HomeMy WebLinkAboutMechanical 99-0840
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No. 99... et/o
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
Date 7 - 6-Q'1 PID # $-.340 - OIl'" 0
Site Address 5'2.,".,5 A "'~ <; w OCl 0 '1) J? 12.1 SD
Lot 3 Block 2. Addition. 7'111- ADON 7TJ N~.e.7H .s~LE: ~.t:S
Owner's Name Kt\-u(a....u.. '^' ~~\ e-Y '-\03- /~~
Address 5~1~ AM "'.1.. F- '.J-<:;:) c-..D UR..
Heating Contractor ~ E:.5" '0 ('- to..l\\~.L.. }{ cc,A.\"- "'" .A. \. ~
Address t ~ '-5 E.. e..c I G '\ ~'1' _ Sv '"'t'-~ A
Telephone # 1"2.... L...f. - l ~ ~o,
A"c..
F~ce Make & Model \~ M ~~~
Model Size c.~ <<10 2...L-f. \/ \L~
Conn. Load
Fuel E '- ~ C . Flue Size
Supply Openings
Return Openings
Input 2 U{ :b oD Output
Edr.
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
HEAnNGORPOWERPUUff
Steam
Hot Water
Radiation
Special Devices _
~
Other Devices
\0/031'100\ ~E 10
C\-,OSED D
. \1'~~C1:\"\1'{
Cfm.
Alterations
TYPE OF WORK
Replacement , New Construction
Repair- Est. Comp. Date
~oO
Est. Cost $ -2. 2..DO Building Permit #
HEATING PERMIT FEE $ 3 ~ - 5 0
STATE SURCHARGE $ .50
1JO ~oo
TOTAL PERMIT FEES $ \ Receipt #
t:1t;- ~O
35tp3/
TYPE OF STRUCTURE
1. Pink
2. Green
3. Yellow
File ; /'
City I.,./"
Contractor
Single Family
Commercial
~
Multi-Family
Other
Two-Family
Industrial
Public
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Remember to add the State Surcharge on the bottom of this application.
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections will be billed at $35.00 each.
House Heating Test Record must be submitted with buildinq permit number before build-
ing certificate of occupancy will be issued.
l:t.EAI CALCULATIONS REQUIRED with number of supply and return openings listed per
room wit" r ler opening. New structures or additions send floor plan with supply
'3 shown. HEAT LOSS CALCULATIONS, PAYMENT AND
IY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
tllOR LAKE, MN 55372.
Irs are 8 a.m. - 4:30 p.m.
......::iT BE INSPECTED (ROUGH-IN AND FINAL) - CAll CITY HALL
447-9850
I hereby apply for a mechanical systems 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 trfS form does not become a permit until signed by the B.UllDING
OFFICIAL; th the work will be in accordance with the approved plan in the
case of all w which requi e rev-t and approval of plans.
I ,?(A, J \A-- . 7-b-~~
V ,pp~j's Si ". '-;t , Da~\
~ ~~~ 7/7/9'
Building Offical's Signature Date