HomeMy WebLinkAboutMechanical 00-0855
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Condttioning
Vent. System - REQUEST FOR INSPECTION
HEATING OR F SENT TO HOMEOWNER 2/03.
Steam - NO RESPONSE. CLOSE FILE
Hot Water _
Radiation
Special Devices
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permtt No.
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
C)-{q-oo PIDII_;;lS-~L
StteAddress 55 () S~()nY'\O\( - S. E.
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Lot L Block ?- Addttion P ~ JJ.-I! 11)
Ownefs Name Un ..It Un l \ \ Arill
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Address 5'i<ll ":".\r\a (\ Y'\("}V\O\r _ ~. E.
Heating Contractor't<:,l )'(Y\5../ :) lln ~rl 4- PI I C.
Address. \,Q, LI V I '\/ n(")~ 0 \,& l~ clA.). S.
Date
-
Telephone II ~~ '';'' - 6' 7 Y' - ,r lC) ':>
Furnace Make & Model :::1l:rLl'\.JL
Model Size
-ru Do ~ rJC CI'3( 0
~6, wO
Conn. load
Fuel \\,)0.1. Flue Size f9 II
Supply Openings
Return Openings
Input 80.000 Output,
,
Edr.
Other Devices
Clm.
TYPE OF WORK
Merations
New Construction
Repair
Replacement
Est. Comp. Date
Building Permtt II
3q.ffi
Est. Cost $
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
U () , 00
Receipt II
~ g'llfS-
TYPE OF STRUCTURE
I. Pink
2. Green
3. Yellow
File
';2
-vvntractor
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)
$99.5Ir,",' __>).- ,,-
$64.50' :!
$39.5q L.J ,
$39.5~1'\; .2..
$39.5~J~L_________,.
RAmAmbAr tn ::Inri thF! Bt~tA !=:1lrr.:h;::r,r~A on thp. hoNom of-rmR A9W'C::Irion_
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 oermtt numbe, before build-
ing certificate of occupancy will be issued.
nONS REQUIRED with number of supply and return openings listed per
per opening. New structures or additions send floor plan with supply
ons shown. HEAT lOSS CALCULATIONS, PAYMENT AND
MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
E. PRIOR LAKE, MN 55372.
City Hall UUO",....:SS hours are 8 a.m. - 4:30 p.m.
ALL 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 this form does not become a e,rmit until signed by the BUILDING
OFFIC~AL; th t the wO,rk will be in ac ~fice with the approved plan in the
case of all rk which reqUire~re . w d approval of plans.
, "-
- / ,
'lA"......( #./#1 , .-/:_...-/ 9-/9.-aJ
L a~~~Y- Date
UBuiRlfng Ollical'. Signature Date