HomeMy WebLinkAboutMechanical 00-0495
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No, _(f() ~OLL-({S"
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
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S~eAddress \51S~ b~ v.. HAl L:>,l N\'\I
Lot ~ Block ~ Add~ion \ 2>~ \t i I AAJ ;)0\ A\'U't\
Owner's Name n YI N <I- A ('oJ rTIf- ~S. n ~
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Address /0 7 33 I [L<J..I) II.I"i...v'
Heating Contractor 0..,-,-~ <:;::::1 p~ S'J<lL<,..Jt' <'\~. #~_
Address /<:; i"; t /11 19 'N: A"'I--
Telephone # . &;,t l-- <.f<..[o ':"6;;""0
Furnace Make & Model ~"'i",cK P'f1..- TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Cond~ioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Model Size
,
Conn. Load
Fuel.
Flue Size
Supply Openings
Return Openings
Input
Output
Edr.
Other Devices
Cfm.
TYPE OF WORK
Atterations
Replacement
New Construction
Repair Est. Comp. Date
Est. Cost $ Building Perm~ # -.s:lJ - 0 L!.9S'
HEATING PERMIT FEE $ 3 q ,.s;-D
STATE SURCHARGE $ .50
TOTALPERMITFEES $ ~D - Receipt# 3'7b<1 I
TYPE OF STRUCTURE
l. Pink
2. GreeD
3. Yellow
File
City
Contractor
Single Family .
Commercial
x
Multi-Family
Other
. Two-Family
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)
$99.50
~
~
$39.50 .'! I 9
$39.50
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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 buildinn !1m!!ill ~ before build-
ing certificate of occupancy will be issued.
!iEAI ~CULATION!'i BEQ1JlRFD with number of supply and return openings listed per
room with CFM's per 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.
C~y Hall business hours are 8 a.m. - 4;30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-4230
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 d approval of plans.
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