HomeMy WebLinkAboutHeating Permit 95-0002 --- : ,. .. ,
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9 �"�tTY QF PRIOR LAKE ,�� � TYPE OF STRUCTURE 3. Yellow - Convactor
3_���y�629�' OTA STREET S.E. permit �o. ��` Single Family � Two-Family Multi-Family
P � KE, MN 55372
Commercial Industrial Public Other �
LICATION i PERMIT
Date PID # S' QD L-�" O3� —D �OB VALUATION FEE
$0 -$1,000 2°!0 of job value, rnin. $20.00
Site Address 16�77 nul_uth Avenue SF
$1,OOi -$10,000 $20.00 for the first $1,000 plus $1.25 for each additional
Lot Block Addition
$100.00 or fraction thereof to and including $10,000.
Owner's Name Ro�drt T� 7iesen - �+45--4(�50
$10,001 -$50,000 $132.50 for the first $10,000 plus $1.00 for each addi-
Address 1h377 nulizth Avenue SE tional $100.00 or fraction thereof, to and incfuding
Heating Contractor Ron's AZechanical, Inc - 445--�5�5 $50,000.
Address 1�12 F,ast Shakopee Avenue Sh ���copee $50,001 and over $532.50 for the first $50,000 plus $7.50 for each addi-
tional $1,000 or fraction thereof.
Telephone # 4`+5 -�35�5
The price of your heating permit includes one rough-in and one finaf inspection.
Furnace Make & Model .S� �'f TYPE OF SYSTEM Additional inspections will be billed at $25.00 each.
/� Warm Air Plants
Model Size C?��O✓� Gravity House Fleating Test Record must be submitted with building permit number before build-
Conn. Load Mechanical ing certificate of occupancy will be issued.
Air Conditioning
`Fuel __ '� � l � , Flue Size Vent. System HFAT GALCULATIONS REQUIRED with number of supply and return openings listed
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HEATING OR POWER PLANT P�r room with CFM's per opening. New structures or additions send floor plan with sup-
Supply Openings ply and return tocations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
, Steam
Return Openings Hot Water APPLICATIONS MAY BE MAILED TO THE CITY OF PRfOR LAKE, 4629 Dakota St.
Radiation S.E. Prior Lake, MN. 55372.
Input QD`Z� Output Special Devices
City Hall business hours are 8 a.m. - 4:30 p.m.
Edr.
Other Devices ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Cfm. qq7.d��n �
TYPE OF WO K I hereby ;- � TQ cnowledge that the information
Alterations Replacemertt � New Construction above is � CLpSED D in conformance with the ordi-
nances arn � g�3014 echanical codes; that this form
Repair Est. Comp. Date does not b+ �AC� ►FFICIAL; that the work will be
� � in acc:ordar __.. ..ork which requires review and
Est. Cost $ • Building Permit # approval of
NEATING PERMIT FEE $ �C� . 4�, /� oY !
STATE SURCHARGE $ .50 p nt's Signature Date
TOTAL PERMIT FEES $ c�. .. �b Receipt # „�.� a ,Q t � ` � ��
Building Official's Signature Date
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