HomeMy WebLinkAboutMechanical 99-553
Site Address
Lot ' Block
Owner's Name
Address
Heating Contractor
Address
Telephone #
Furnace Make & Model
Model Size
Conn. Load
Fuel
Supply Openings
Return Openings
Input.
Edr.
Cfm.
Meralions X.
/
Repair
Est. Cost $
~
~L-,41 f'y; \L ~~
"'40 S-~ G~ k~. Ytre8
hlz.- 93Cj,- ~ 3>0~
HEAT CALCULATIONS REQUIRED with number of supply and return openings listed per
HEATING OR POWER PLANT room with CFM's per opening. New structures or additions send floor plan with supply
Steam tt1. and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
Hot Water';><" R.rl:O~ 61( APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
Radiation CREEK AVE. S.E. PRIOR LAKE, MN 55372.
Special Devices
Addition
Flue Size
TYPE OF SYSTEM
Warm Air Plants
Gravity _
Mechanical
Air Conditioning
Vent. System
Output.
Other Devices
1. Pink
2. Green
3. Yel10w
File
City
Contractor
TYPE OF STRUCTURE
-----
Multi-Family
Other.
Single Family
Commercial
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
C ::::~ --=:>
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 buildina permit number before build-
ing certificate of occupancy will be issued.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL
447-9850
TYPE OF WORK U
. Replacement New Construction ^ \ h Y
.... (l t~
. Est. Comp. Date /
Building Permit # J 131f?fJ'
S i.<;o -
.50
fo. eo Receipt #. 3') 8 I
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
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 this form does not become a permit until signed by the BUILDING
OFFIC ~L; that the work will be in accordance with the approved plan in the
case 0 all tlork which requires review and approval of plans. / /
^'\~.~ ,I ~ 5t(7/f~
I ~l \:p 'c t's Ig ~;;;fp~
, 811ding Offical's Signature ~ Oat, /