HomeMy WebLinkAboutMechanical 99-1319
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No. qC; - /3 /Cf
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
Date \l ~.. -<1q PID# 25- 032 - 005 - 0
Site Address 4 D ~D r,,~~\ Al ~CcC> ~ (<:... Je./SD
Lot 7 Block 5" Add~ion. 6leAINWOOD
Owner'sName ~ I A t...)1\...\~ h~ ~u ~~,.. '-\~ c- Lto'-=>
Address 1....\ b ~ (;;) 0A.A' N ~ o..c..D L\ f-
Heating Contractor ~ c.....::.... U51.I'.ST, PI. L ~<Ct"\T\.N G " A \.t.....
Address ( ~,<~ C- A '11 ~ '" 5T SU '-~ <=- ~
Telephone # J., I L - 72"1 - ) s<q~
Furnace Make & Model .2.:-:.' , \')
Model Size l' r.. () \-=l \ "'2.... Go. A <?-~ (L.
TYPE OF SYSTEM
Warm Air Plants
Gravity .
Mechanical
Air Conditioning
Vent. System .
HEATING OR POWER PLANT
StE
Ho
Ra REQUEST FOR INSPECTION
Sp SENT TO HOMEOWNER 1/03.
_ NO RESPONSE. CLOSE FILE
Ot~
Conn. Load
Fuel j-..' ~ G~~Flue Size
Supply Openings
Return Openings
Input IWI DOD Output
Edr.
Cfm.
Alterations
TYPE OF WORK
Replacement X New Construction
Est. Comp. Date
CJo'\ - 00
Est. Cost $ "?:> 5 2. -.J Building Perm~ #
HEATING PERMIT FEE $ b ~ 39..50
-
STATE SURCHARGE $ .50
r.... c.. ~ 4.0.00
TOTAL PERMIT FEES $ _ ~ 0 Receipt # .
Repair
99-/3/9
~
..3rA-9B
TYPE OF STRUCTURE
1. Pink
2. Green
3. Yellow
File
City
conV'
Single Family
Commercial
~
,
Two-Family
Multi-Family
Other
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 "~'. r:i"{~:<' f
$64.50 . \ i. ]
$39.50
C $39.~:\ NOV - 8 1999
$39.50 ~
(lS'\
, I
I ~
Remember to add the State Surcharge on the bottom of this appliea/lon.
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.
HEAT CALCULATIONS REQUIRED with number of supply and return openings listed per
---m with CFM's per opening. New structures or additions send floor plan with supply
return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
'L1CATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
::EK AVE. S.E. PRIOR LAKE, MN 55372.
Hall business hours are 8 a.m. - 4:30 p.m.
_ ___ 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~hiS form does not become a permit until signed by the BUILDING
OFFICIAL; t t the WO~k 'fJt.II be I . accordance with the approved plan in the
case of all ~ k Wh~h r. u. e~ view and approval of plans.
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--SuilCfrng Oftlcal'S SiY"CllU't:l -
Date
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