HomeMy WebLinkAboutMechanical 99-1188
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No.
Prior Lake, MN 55372
qtldi Y'Y
TYPE OF STRUCTURE
I. Pink
2. Green
3. Yellow
File
City
Contractor
HEATING APPLICATION I PERMIT
9h9/9~ PID# zs-9o/- 005-0
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Site Address / ~ S I " _ - FII!!!.,:JAlIC-t-I;J
,
/'? ~ j "2:;. .~ /3() ,/tV o.s
H~WOOD I1Pt5.
Single Family
Commercial
Two-Family
Industrial
Multi-Family X
Other
Public
Date
(/Nit
Fee Schedule
Heating Contractor L.-pO /TPpt'{.,.II'hVCA::;,
Address ~ ?'Z.- Z- 5S77Y s;r. C;,,:J,K O~(....G
Te!!phone # ~ ~ / - 77 7 -? '1/5
r.P . AA ~ J
~ake & Model /"~L / / A/ TYPE OF SYSTEM
....r~ -f"Z- Warm Air Plants
Gravity .
Mechanical
Air Conditionina
~Sl2'(s
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
Lot
Block
Addition
Owner's Name
Address
Remember to add the State Surcharge on the bottom of this application.
Return Openings
CLOSED DUE TO
INACTIVITY 1/1/03
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 Dermit number before build-
ing certificate of occupancy will be issued.
HEAT CALCULATIONS 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.
Model Size
Conn. Load
Fuel Flue Size
Supply Openings
Input Output
Edr.
Cfm.
"""'.....'Cl' UtlVlces
City Hall business hours are 8 a.m. - 4:30 p.m.
Other Devices
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-9850
Alterations
. Replacement
TYPE OF WORK
X
r
Est. Comp. Date
New Construction
Est. Cost $
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
Building Permit #
...39. SO
.50
4-0.00
Receipt # .
3(,Z-71
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 a\ wo.rrkk w wt icch requires review and approval of plans.
~~ t -. 9'-2?-?'
J::. '.. A. p. .P.I.i~~1Yf S.ig.npnt!.~~_.7.L..... ' Date
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f r,~ ",-v.~v: ~ .'/ 'J. ~'~'.- '... 7/ L
i' "'Building OfficaJ's Signature ~- ( D e
Repair