HomeMy WebLinkAboutMechanical 99-135
CITY OF PRIOR LAKE Me r
16200 Eagle Creek Av. S.E. Permit No. 99'-/3 .)
Prior Lake, MN 55372
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File
City .
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TYPE OF STRUCTURE
HEATING APPLICATION I PERMIT
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Site Address 5 L/ 7 C:; WI '/ !t1W ~c t. 7/J..
Lot C Block Addition A J /~o r o~ Sfolo I rr-aC7-.
Single Family
Commercial
;<
Two-Family
Industrial
Public,
Multi-Family
Other
Date
Fee Schedule
Industrial, commelr I Multi-Family I __ 1 % of job cost ($39.50 minimum)
,. Residential, Heatin ~v $99.50
Owner's Name. {'l"'"'Mc, D.u <./L<2- Residential, Heati y $64.50--
Address 3 LJ 7 ( Jj (ow~, tL Ta sesidentia,I, Gas Fireplace \ ~ $39.50
/J1 - ~ ./I 1\ +,; / / esident~AgIItions & Alteratio\ $39.50
Heating Contractor JY1.4~ 1<12.-'1-/1.. rr-r~,; sidentiaV Only ~ $39.50
Address /(,~ ~~ 6e,ve~e ,4i"J'L ~.sG~.I.;-I /11~
/ /.., 1/'32 -<J ,,~~ t,;Rem \ ~IO add 4:le urcha<ge on the bottom 01 this application.
Telephone' .. ~ -.. 4-" / ~ 'V" . ~
Furnace Make & Model 1/1!./1l~~:;;' TYPE OF SYSTEM II ~ ~he price of your heating permit includes one rough-in and one final inspection.
G- U q 3 .4ac;o IJ-f~ Warm Air Plants - V--
Model Size 711: ~ Gravity -~ Additional inspections will be billed at $35.00 each.
Conn. Load M.echani~1 . ... J House Heating Test Record must be submitted with buildinq permit number before build-
I , Air Conditioning . ~ ing certificate of occupancy will be issued.
Fuel AJK1- Flue Size 3 I~c Vent. System ...
v.I- HEAT CALCULATIONS BfQUIRED with number of supply and return openings listed per
Supply Openings HEATING OR POWER PLA :r room with CFM's per opening. New structures or additions send floor plan with supply
Steam and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
Hot Water APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
Radiation CREEK AVE. S.E. PRIOR LAKE, MN 55372.
Special Devices
Return Openings
Input
Output
City Hall business hours are 8 a.m. - 4:30 p.m.
Edr.
Cfm.
Other Devices
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-9850
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
Building Permit #
totl. i!)O
.50
& s. ()O
Receipt #
~L11 3S
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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tJ ;;;:unt's S~naly-
(j Building Offical's Signature
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Date
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Date
TYPE OF WORK
Est. Cost $
Replacement )t.
Est. Comp. Date
;1.~.tn)
New Construction
Alterations
Repair