HomeMy WebLinkAboutHeating Permit 95-0051 ----1°+ 1. Pink - File
�� `� � �` TYPE OF STRUCTURE 3. Yellouv - Co
� .� + E��F! PRIOR LAKE � �
� r�'n fi��29 D�1�CpTA STREET S.E. Permit No. �� �� Single Family �_ Two-Family Mufti-Family
�'�lrRl , KE, MN 55372
Commercial Industrial Public Other
ICATION / PERMIT
Date PID # o�� ODI -���j -a �OB VALUATlON FEE
_ $0 -$1,000 2% of job value, min. $20.00
SiteAddress � ' CO�O�'O�.00 �' ,
Lot � 81ock � Addition --�' $1,001 -$10,000 $20.00 for the first $1,000 plus $1.25 for each additional
$1QO.OQ or fraction thereof to and ir�luding $10,000.
Owner's Name �rhnv SGh�n�l C��('
$10,001 -$50,000 $132.50 for the first $10,000 plus $1.00 for each addi-
Address �J`��J� (`_c����'Clr� �'�- , tional $f00.00 or fraction thereof, to and including
Heating Contractor 6�[901M i�f1G��ill Q, a- � i(' Cpn� $50,000.
Address _�� W qa n C� �'�' .,, �� m�h n� . 4a $50,001 and over $532.50 for the first $50,000 plus $7.50 for each addi-
tiona) $1,000 or fraction thereof.
Telephone # r�$� - �SSo�?
Carrie�' The price of your heating permit includes one rough-in artd one final inspection.
Furnace Make & Model _ WA�/OTO - I O£� NPE OF SYS7EM will be bil�ed ai $25.00 each.
warm Air P�ants _ CLOSED DUE TO
Model Size �'1� �Og Gravity �ecord must be submitted with buildinq �ermit number belore build•
Conn Load 35000 Mechanica� �C .� INACTIVITY 8/3O/O 1 ►ancy wi�� be issued.
Air Conditioning _
Fuel N �Csc�s . Flue Size '� Vent. System iS RE�UIRED with number of supply and return openings listed
HEATING OR POWER PLANT Per room with CFM's per opening. New structures or additions send floor plan with sup-
Supply Openings /O ply and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
! Steam
Return Openirtgs tp Hot Water APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 4629 Dakota St.
Radiation S.E. Prior Lake, MN. 55372.
Input - 7 0 pp0 Output S(o OO �3 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. QOO
447-4230.
TYPE OF WORK I hereby apply for mechanical systems permit and I acknowledge that the information
Alterations ReplacemeM �,_ FVew Construction above is complete and accurate; that the work will be in conformance with the ordi-
nances and codes of the city and with the state building/mechanical codes; ihat this form
Repair Est. Comp. Date 3-(o -Q S does not become a permit until signed by the BUILDING OFFICIAL; that the work will be
� in accordan with the �pprov� n the case of all work which requires review and
Est. Cost $ ( � �� o Buitding Permit # ----�'`� appro� p��
HEATING PERMIT FEE $ � 1 , a5 �? .-3 _ c�
STATE SURCHARGE $ .50 i t's ' nature Date
TOTAL PERMIT FEES $ a �•�S Receipt #�q ��
Bui ing Official's Signature Date