HomeMy WebLinkAboutMechanical 99-0051
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CITY OF PRIOR LAKE Me
16200 Eagle Creek Av. S.E. Permit
Prior Lake, UN 55372
Date
Site Address
10 "31../-1
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Addkion
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:IF,,,-, \.II Pit;..) (O'f-J T,.,.,c
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310 2:53
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I ) D V . R9~,b1\ add the Slata Surcharge on Ihe bonom of this applicaliDn.
TYPE OF SYSTEM The ~f your heating permit includes one lI)ugh-jn and one tinal iJlspec!ion.
Warm Air Plants ~
Gravity dditional' ections win be bifled at $35.00 each.
~echani~1 '~OUS~lng st Record must be submitted wt1h building !)A~mi' ""mbe! before buird-
Air Conditioning (Y~~. c ' te of occupancy will be issued.
Vent. System .'
CALCULATIONS REOUIRED with number of supply. and relurn openings listed per
HEATlNG OR POWER PLAN" .- f/ ilh CFfvfs per opening. New structures or addiUons send floor plan with supply
Steam .. ...... ~ a relum locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
HoI Wat&r 1""':. \ Y - C(;~ A.P L1CATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
Radiation " \ ~ CREEK AVE. S.E. PRIOR LAKE, MN 55372.
specialDeviceV " City Hall business hours are 8 a.m. - 4:30 p.m.
Other Devices ALL WORK MUST BE INSPECTED (ROUGH-IN AND F'NAL) - CALL CITY HALL
Lot
Block
OWner's Name
A.ddl8ss
Healing Contractor
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Address .
Telephone #
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Furnace Make & Model
Model Size
Conn. Load
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Flue Size
Fuel
SUpply Openings
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Return Openings
Input
Edr.
Output
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TYPE OF WORK
New Conslruction
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Alterations
Replacement
Est. Comp. Date
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Repair
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Est Cost $ ll' .
HEATING PERMIT FEE $
, Building Perml'
'=> 7 . 00
9 ~- 49
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STATE SURCHARG!= $ - .50
TOTALPERMlTfEES $-' 1. 6'"'0. Receipt. 34 ~C:;3>
TYPE OF STRUCTURE
2. 6l'CllD
3. YdIow
Ciry
Coo1raclDr
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Two-Family
Industrial
Mulli-Famly
Public Other
Fee Schedut.e
~..st($39'5~
- $99.50
$84.50
$39.50
$39.50
$39.50
Industrial, Commercial &. Multi-Family
Residential, Healing & AC
Residenlial, He~g Only
Residenlial, Gas e
Residenlial,4dd' terations
Residenyl
.
447-9aso
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; lhat Ihe work will be tn conformance
with the ordinances and codes of the city and with the slate buildingfmechanical
codes; that this form does not become a permit until signed by the BU ILDlNG
OFFICIAL; that the work will be in accordance with the approved plan in the
. :s; EW~ equlres review and approval 01 p'e~si ,;2 'd? '1
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Building Ollical's Signal~ I Dale ·
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