HomeMy WebLinkAboutMechanical 00-0464
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Fi'"
City
Contractor
CITY OF PRIOR LAKE Me
16200 Eagle Creek Av. S.E. Permh No. 00 -() tM-
Prior Lake, MN 55372
TYPE OF STRUCTUR~
)(
Single Family .
Commercial
_ Two-Family
Industrial
Multi-Family
Other
Public
Date
Fee Schedule
Industrial, Commercial & Multi-Family
Rc.; ~. . :al, Heating & AC
Rc";~,,..:al, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
~~ JUN - 8 200U
~
Healing Contractor
Address
~emember to add the State Sureharge en the beltem ef this applielltiec.
Tele~ne# .
FuJa'ceGMake & Model tiYlJfo:J-'f5
Model Size Yatek ::L-- 1-$Y\
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Condhioning
Vent. System
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 buildingl1mIDi1 nllmbAr before build-
ing certificate of occupancy will be issued.
I::If& CALCIII AT''lliS, REOIIIRFD whh number of supply and return openings listed per
Ir opening. New structures or addhions send floor plan whh supply
shown. HEAT LOSS CALCULATIONS, PAYMENT AND
Y BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
RIOR LAKE, MN 55372.
Conn. Load
Fuel.J eJ-I~(_
'^
Flue Size
HEATING OR POWER PLANT
Steam
Hot Water 10/03/2001
Radiation. CLOSED DUE TO
Special Devices _ INACTIVITY
Supply Openings .
Roturn Openings .
Input Sl-3;> ~Output
Edr.
lurs are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-4230
Other Devices
Clm.
,
TYPE OF WORK
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 ot:1f[eQun::;:proval of Plans(Q fro ( cO
Applic~~~/ ,. Date/.
~/8/(}D
1 Dille
x
Merations
Replacement
Est Comp. Date
(g0~7~n
t'J7) -04:/04-
, ,
Repair
Est. Cost $ Building Perm~ #
HEATING PERMIT FEE $_ -:2." <; . SD
STATE SURCHARGE $ .50
TOTAL PERMIT FEES $ L{ o. CD Receipt#
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