HomeMy WebLinkAboutMechanical 00-0421
HEATING OR powr
Steam
Hot Water 1010312001
Radiation CLOSED DUE TO
Special Devices INACTIVITY
CITY OF PRIOR LAKE MC
16200 Eagle CreekAv. S.E. Permn No. .Q7"\...6L.1;2)
Prior Lake, MN 55372 :.,,'
HEATING APPLICATION I PERMIT /If'
f)-;)~-lY"" PID# 9-S- ~ 34;1'- 0d6-0
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Lot --b- Block '3 Addttion_~9.J 3 l\r'fM,
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Ownefs Name.J1Jn r IL :\ OP 'C}( () /
I
Date
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Address
Heating Contractor ~. l'C ('\ ,;;, 11 i ( Q..
Address J.iJ v... 9.. \ '\2hv\ 0
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lelSpnOnaJl /i-I-'-lA I '~.J
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Furnace Make & Model
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Condttioning )(
Vent, System
5~{', AIU)( ol./~
Model Size
Conn, Load
I
I
I'
Fuel
Flue Size
Supply Openings
Return Openings
Input
Edr,
Output
Other Devices
Cfm,
Merations
TYPE OF WORK
X
New Construction
Replacement
Repair
Est, Cost $
HEATING PERMIT FEE $
Est. Comp, Date
Building Permn #
_~q.SO
rro - O'-l.~ J
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
L{ 0.0 (')
Receipt # ~
TYPE OF STRUCTURE
I. Pink
2. Green
1 Yellow
File
City
Contractor
Single Family
Commercial
>< _ Two.Family
Industrial
Public
Multi.Family
Other
Fee Schedule
Industrial, Commercial & Multi.Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Addnions & Alterations
Residential, AC Only
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Remember to add the State Surcharae on the bottom of this aoolication.
The price of your heating permit includes one rough.in and one final inspection.
Additional inspections wili be bilied at $35.00 each.
House Heating Test Record must be submitted with buildina. oermlt !ll!!I!t&r before build-
ing certificAt~ ^' . Jpancy wili be issued.
IS. RFOIJlRFD with number of supply and return openings listed per
opening. New structures or additions send floor plan with supply
10wn. HEAT LOSS CALCULATIONS, PAYMENT AND
SE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
JR LAKE, MN 55372.
.
~"y Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FIN~ OAtL 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 appraved plan in the
case of all~ork :hiCh reqUi~ review and approval of plans.
. 'lAO~O.-t./; /~/,U'JJ ,'<;-";(3-bfY
r Applic~t'~ Signature Date
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