HomeMy WebLinkAboutMechanical 99-750
Model Size
Conn. Load
Fuel
Supply Openings
Return Openings
Input
Edr.
Cfm.
A~erations
)(
Repair
Est. Cost $
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
CITY OF PRIOR LAKE
16200 Eagle CreekAv. S.E. Permit No. q9- 7.5lJ
Prior Lake, UN 55372 ' .
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical _ .
Air Conditioning( X. ~ ?JXjR..I4a3.iJ)
Vent. System
HEATING OR POtp-- 1
Steam . 1 0/03/200 D~E ,\,0
Hot Water OSED
Radiation CL C'I\'l\'I~
Special Devices _ \~N
Flue Size
Output
Other Devices
TYPE OF WORK
Replacement ,
Est. Comp. Date
Building Permit # . C19- 7,StJ
3G.50
.50
40.(10 Receipt # 355/'9
New Construction
TYPE OF STRUCTURE
1. Pink
2. Green
3. Yellow
File
City
Contractor
Single Family
Commercial
y.
Two-Family
Industrial
HEATING APPLICATION I PERMIT
Date lo.lilt:jLj PID" 2..5 -.33e - 004- 0
Site Address f Ip II 17 ~r J ^-LA ~f: -he_ ,.e /5.0
Lot 4-- Block I Addition NIf..L)6eN65SPOND5 2. NO
Owner's Name K"6J ll,~___J-<-te..u 9 ~ .~
....-
Address ~r
Heating Contractor .:piLf-~ YVt~M II' Ct (
Address 1(PY3 Lc~trN {1vf-S 'Rt-ffA-fudA ~~<.
Telephone # lt2{~ ~(p ,(pll
~ Make & Modellr!rlJ..J/2...{ 0L
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
Public
Multi-Family
Other,
1% of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.QO
~
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 Heati..- ~ 'st Record must be submitted with buildinq, permit number before build-
i..- ~cupancy will be issued.
)NS REQUIRED with number of supply and return openings listed per
r opening. New structures or additions send floor plan with supply
shown. HEAT LOSS CALCULATIONS, PAYMENT AND
. BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
.. .....c. 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 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
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.
&/7(19
Date
~//7hq
I' Date
fJ~Alu:L~ J
- pli Si
J. '.I /r
ff* ...;. .<~"i;;"~
Building Officars Signature