HomeMy WebLinkAboutMechanical 99-730
CITY OF PRIOR LAKE
16200 Eagle Creek Av. S.E. Permit No. !j..,Cl - 7.3D Single Family
Prior Lake, MN 55372 '
~
1. Pink . File
2. Green - City
TVPF OF STRUCTURE 3. Yellow - Contractor
Two-Family Multi-Family
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning ~
Vent. System . ~\)\) \ ~ <\0
HEATING OR POWL \ \)I\)'~~\) \)\J
Steam. C,-,O \~\'\~
Hot Water ~~C'\
Radiation
Special Devices
Date
Site Address
Lot I Block
Owner's Name -:y "T
Address 1 b \, )
Heating Contractor
Address . \... fc. \ ~
Telephone #
Furnace Make & Model
Model Size
Conn. Load
Fuel C:; L~'-. Flue Size
Supply Openings
Return Openings
Input )..4 .OOC> Output
Edr.
Other Devices
Cfm.
Alterations
TYPE OF WORK
~
New Construction
Replacement
Repair Est. Comp. Date
c:)C:>
Est. Cost $ "J.. , ~ '1 . Building Permit # q q - 130
HEATING PERMIT FEE $~39.6D
STATE SURCHARGE $ .50
TOTALPERMITFEES ~ Receipt#. 35503
40.00
Commercial
Industrial
Public
Other
JOB VALUATION
$0 - $1,000
$1,001 - $10,000
FEE
2% of job value, min. $20.00
$10,001 - $50,000
$20.00 for the first $1,000 plus $1.25 for each additional
$100.00 or fraction thereof to and including $10,000.
$132.50 for the first $10,000 plus $1.00 for each addi-
tional $100.00 or fraction thereof, to and including
$50,000.
JJN - A !999
$50,001 and over
$532.50 for the first $50,000 plus $7.50 for each addi-
tional $1,000 or fraction thereof.
The price of your heating permit includes one rough-in and one final inspection.
Additional inspert:...ns will be billed at $25.00 each.
H""
Record must be submitted with puildinCU)ermit number before build-
l8ncy will be issued.
~ REQUIRED with number of supply and return openings listed
....dr opening. New structures or additions send floor plan with sup-
~111 locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
. LICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 4629 Dakota St.
S.E. 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 mechanical systems permit and I acknowledge that the information
above is complete and accurate; that the work will be in conformance with the ordi-
nances and c:odes of the city and with the state building/mechanical codes; that this form
does n~, become ap .ermit, until signed by the BUILDING OFFICIAL; that the work will be
in acco nee with the approi7 plan in the case of all work which requires review and
approvaJ plans" II ~ I....". _
Lt. 1\ ." ~ { q q
~~.~Si9~.,tf, "7,. ' Date ,
~ l'At~b'pt<:- ~//5 /qq
. Building Official's SiQnature ' Dale