HomeMy WebLinkAboutMechanical 00-0739
HEATING APPLICATION I PERMIT
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Heating Contractor ~:j</)y n<i5t/i Iff 1-11' /J /J Yr/ <>/- I:f I ('!
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Date
S~e Address
T Alephone #
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Perm~ No. ()(). 0 7.~
Prior Lake, MN 55372 ,- I
Model Size
Furnace Make & Model
Conn. Load
Fuel
Supply Openings
Return Openings
Input
Edr.
Cfm.
A~erations
Repair
Est. Cost $
Flue Size
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Cond~ioning .J(
Vent. System
_ ~ The price of your heating permit includes one rough-in and one final inspection.
.{I\ Additional inspections will be billed at $35.00 each.
- ~lY
If!' House Heating Test Record must be submitted with building Dermit number before build-
.c;<;(,)Ar\.lx()30 ;2.~ ing certificate of occupancy will be issued.
-rlJV
Output
HEATING OR POWER PLANT
Steam
Hot Water 001
Radiation 10/03/2 DE TO
Special Devices _ CLOSED D
INACTIVITY
Other Devices
TYPE OF WORK
Replacement
New Construction
_ Est. Comp. Date
Building Perm~ #
(){) -0739
/
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
::(C)KO
.50
'-/U - O() Receipt #
~ 5<~d;z:.,
TYPE OF STRUCTURI;
1. Pink
2. Green
3. Yellow
File
City
Contractor
Single Family
Commercial
/
Multi-Family
Otber
Two-Family
Industrial
Public
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, HBating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1 % of job cost ($39.50 minimum)
$99.ql)--:----c2 (i
-', ,. -: L_._'
$64.50 \;0' - -.!
$39.50 i\ . 1'\ I'
$39.50 ;,\ \ iii' 1 \\U\
03!1.50_\\i~l _ \~\
Remember to add the State Surcharge on the bottom of ti'W ~~~I;~"lIon.
!::IEAI r.Alr:1 " 6,TI()~ REQUIRED with number of supply and return openings listed per
r""-' .' opening. New structures or additions send floor plan with supply
;hown. HEAT LOSS CALCULATIONS. PAYMENT AND
BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
lOR LAKE, MN 55372.
's are 8 a.m. - 4:30 p.m.
___n" 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 permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case of a~ork which requiresJeview a~d approval of plans.
~J . / ~~d~.L-<~ 8- /L/--O<':J
'1' Applical)l"s~!1' Date
f!!).{8.00
Date