HomeMy WebLinkAboutMechanical 99-758
CITY OF PRIOR LAKE MC
16200 Eagle Creek Avo SoE. Permit No.
Prior Lake, MN 55372
99- 758
HEATING APPLICATION I PERMIT
f - IY"''19 PID.-Z.5-t..tJ4- OIB-O
Site Address _ \ b:t'., c..- ~~\<..'t:> \t')E:.. L, rt?...r ~.J'- ~.~ -
lot /C:. Block Addition~J'9.NIV'~ IItdiH f//5W ....'3IeO
OWner's Name_ h ~\\"<' (., &\ {".,,,,-~
Address Jb:+ \ l c.. ~~~~\ G E:- (:" ~'\..~ ~ ."
Heating Contractor ~\ (:) ~\V, \..... )-\.tPi\\ ~ t'7 '" A \ ~
S,- C. l H't...S
Address '~I~ c..._~ 4 I 5'- ....Ju \~~ ^ ~4a1
Telephone' -----617--iL Lt- t8QC,
~Make&Model ~L)D
Model Size ~ U~~ ~,,~
Date
Conn. Load
Fuel ~\...~c.....
Supply Openings
Return Openings
Input q.,,-\ :OO.J:L- Output
TYPE OF SY,;, I CAt
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System.
HEAnNG OR POWEP I" -
Steam. 0/03/'2.00\ ~ 1'0
Hot Water \ ED DD}.j
Radiation Cl.,OS rt~
Special Devices _l1'~~C'tl~
'Y!:
Flue Size
Edr.
Cfm.
Other Devices
TYPE OF WORK
Alterations
Replacement
New Construction
Repair Est. Comp. Date
Est. Cost $ -1...1-,9,(') - 0'0 Building Permit. Q9, 7513
HEATING PERMIT FEE $ ?,.q. 50
STATE SURCHARGE $ __. ~~_:
TOTALPERMITFEESC()'~'. 355.30
TYPE OF STRUCTURE
1. Pink
2. Green
3. Yellow
File 1---/
City
Contractor
Single Family ---X
Commercial
Two-Family
Industrial
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
$39.50
C $39.Q
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 TAst Record must be submitted with buildinq permit number before build-
ing c"''''~ :cupancy will be issued.
)lf5. 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
. ..-iIOR LAKE, MN 55372.
"'It}' 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
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
OFFICI~!i :a, 'he w~r~.fI,. ill': be In accordance with the approved plan i.n the
case of f.:..,02rWh~res review and approval of Plan" _ \ 4 -q<i
~~ 6/t;iq<j'
Buirding Offical's Signature Date