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TYPE OF STRUCTURE
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9t1~31
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No.
Prior Lake, MN 55372
Multi-Family
Other
1 % of job cost ($39.50 minimum)
$99,50
$64,50
$39,50
$39,50
$39,50
Public
Two-Family
Industrial
Industrial, Commercial & Multi-Family
Residential
Heating & AC
Heating Only
Gas Fireplace
Additions & Alterations
AC Only
Single Family
Commercial
Fee Schedule
Residential
Residential
Residential
Residential
HEATING APPLICATION I PERMIT
,5"-/1./1- Od?.3-0
1e0 Ie/Sa
PID'
NtJe7HNOOO
Date 5/ .,;>-c
Site Address ....LG
Lot 9</ BIock_
Address
Heating
Address
TYPE OF SYSTEM
Warm Air Plants .-!
Gravity
Mechanical _ REQUEST FOR INSPECTION
Air Conditioning J. SENT TO HOMEOWNER 1/03
Vent. System _ NO RESPONSE. CLOSE FILE
Remember to add the State Surcharge on the bottom of this application,
heating permit includes one rough-in and one final inspection
1S will be billed at $35,00 each,
The price of your
./
Telephone'
Furnace Make & Model
t,fJ.OO 0
building oermit number before build-
Record must be submitted with
:upancy will be issued,
INS REQUIRED with number of supply and return openings listed per
"""" ...." v. ,., '" ",or 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,
City Hall business hours are 8 a,m, - 4:30 p,m,
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL)
447-9850
CALL CITY HALL
HEATING OR PO~_n
Steam
Hot Water _
Radiation _
Special Devices
Devices
Other
Conn. Load
Fuel ----.If.-Flue Size
Supply Openings --..1.
Return Openings ~
Input U. 0 01 Out
Edr,
Model Size
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,
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New Construction
;35352-
Receipt'
Building Permit .
::39. $"V
TYPE OF WORK
.50
C'/O
Comp, Date
Replacement
'0.
Est
HEATING PERMIT FEE $
$
$
STATE SURCHARGE
TOTAL PERMIT FEES
Cfm,
Alterations
Repair
Est. Cost $