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HomeMy WebLinkAboutMechanical 99-510 Dale S~e Address Lol / Owner's Name Address Healing Conlraclor Address Telephone II CITY OF PRIOR LAKE MC 16200 Eagle Creek Av. S.E. Permil No. Prior lake, MN 55372 qq-s/o TYPE OF STRUCTURE l. Pi.... 1. (inxn 1. Ydlo... Single Family Two.Family Induslrial HEATING APPLICATION I PERMIT !\/~ /qq PID # 3-5-/33- OqO-O I , . . -:30/.9 h ~ rjJJ ~/5D Block 5 I Addilion f!pR. / IV (E; LA K..6 77J W /I/. rn~/)t~ ~ Commercial Fee Schedule AIf'I8d Fireside aDa ~lreslCl8 ComIr license "20080111 iuw N. ~BJMlWAV& Roseville, MN 55113 .=:; :.": J3-2S81 Induslrial. Commercial & Mulli-Family Residential, Healing & AC Residenlial, Heating Only Residenlial, Gas Fireplace Residenlial, Addilions & AUeralions Residential, AC Only P uLJlic Mulli.Family Olher 1 % 01 job cosl ($39.50 minimum) $99.50 $64.50 . $39.50 $39.50 $39.50 Furnace Make & Model~ N ft,(:tI) YR, ~t.o Remember 10 add Ihe Slale Surcharge on Ihe bollom ollhis applicalion. Model Size Conn. load Fu~l-.0cw Supply Openings Relurn Openings Inpul Edr. elm. Aheraliens Repair Esl. Cost $ ---1..1.fX). U) HEATING PERMIT fEE $ STATE SURCHARGE $ TOTAL PERMIT FEES $ Flue Size TYPE OF SYSTEM Warm Air Planls . Gravity Mechanical Air Condilioning . Vent. System file 3: Ci., DJ ContuclOf '< I o U1 I \C \C o .... o \C iJ " ..I. "l ID Vl ..I, a. ID n o "l ::l ID "l The price 01 your heating permit includes one rough-in and one linal inspection. Additional inspections will be billed at $35.00 each_ House Healing Tesl Record must be sulJmiUed wilh puildinl~ llrunlllll.!l!lt2.c1 belo.e build. ing cerlilicale 01 occupancy will be issued. CLOSED DUE TO INACTIVITY 8/30/01 J-iEAT CAlCllLATIOt:!S BJ;QUIREQ wilh number 01 supply and relum openings lisled pI - _.:.1_ "~U'~ nor n'1ening. New slruclures or additions send IIoor plan Wilh supply 'Wn. HEAT LOSS CALCULATIONS, PAYMENT AND E MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE IR LAKE. MN 55372. HEA TlNG OR POWE" Slearn Hol Waler Radialion Special Devices _ OutpUI dJ.()(J) ; are a a.m. . 4:30 p.m. Olher Devices 0'1 .... N 0'1 IN IN AL.L. "v.... mu u. - - INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL 447~2JO 00 00 I hereby apply lor a mechanical syslems permil and I acknowledge Ihalthe 00 inlormalion above is complele and accurate; Ihallhe work will be in conformance ,J:l willi Ihe ordinances and codes or the city and with Ihe slale building/mechanical codes; Ihal Ihis lorm does nol become a permit until signed by the BUILDING OFFICIAL; thai the work will be in accordance wilh Ihe approved plan in the case 01 all work which requires review and approval 01 plans. TYPE OF WORK Replacemenl New Conslruclion \/1 f .C\/Jr~ jq4 I' I - Building Perm~ # qq - 5/ () Est Camp. Dale 39.50 .50 40.00 Receipt II 35'/52- ~& 8uihling OUicars Signaluro sfs7c;t;; , , Daie 0/7/t:Jq DOale iJ , o ....