HomeMy WebLinkAboutHeating Permit 95-0118 (`-'-"� = �� --� - ` - � ' � 1. Pink - File
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��� CITY OF PRIOR LAKE TYPE OF STRUCTURE 3. Yellow - Convactor
� .. 5� 46 AKOTA STREET S.E. permit No. �� Singte Family Two-Family Multi-Family
LAKE, MN 55372
Commercial industrial Public Other
HEATING PLICATION / PERMIT
Date 0 S/ 31 / 9 5 p�p # 2 50f 60020 �B VALUATION FEE
$0 -$1,000 2% of job value, min. $20.00
Site Address 5299 140TH ST WEST
Lot � Block Addition ,�,�,�� fi�,� �' L� ;,,� $�'�1 -$10,000 $20.00 for the first $1,000 plus $1.25 for each additional
�a'• $100.00 or fraction thereof to and including $10,000.
Owner's Name LINDA & MICHAEL SMITH
$10,001 -$50,000 $132.50 for the first $10,000 plus $1.00 for each addi-
Address 5299 140TH ST WEST tional $100.00 or fraction thereof, to and including
$50,000.
Heating Contractor RON' S MECHANICAL , INC .
Address 1812 EAST SHAKOPEF AVE SHAKOPEE, MN �50,001 andover $532.50 for the first $50,000 plus $7.50 for each addi-
5 5 3 7 9 tional $1,000 or fraction thereof.
Telephone #�� �g �,� ating permit includes one rough-in and one final inspection.
The �riro �f ,,,..�-'-�
Furnace Make & Model TYPE OF SYSTEM TO vill be billed at $25.00 each.
Warm Air Planis _ � DUE
� Model Size Graviry �� �cord must be submitted wfth uilding nermit number before build-
Conn. Load Mechanical �p,CTIVITY 8/3 0/O 1 ,��, w��� �e �SS�ea.
Air Conditioning�
� Fuel Flue Size Vent. System _S REQUIRED with number of supply and retum openings listed
HEATING OR POWER PLANT Per room with CFM's per opening. New structures or additions send floor plan with sup-
Supply Openings ply and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
Steam
Return Openings Hot Water APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 4629 Dakota St.
Radiation S.E. Prior Lake, MN. 55372.
Input 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. 447-4230.
TYPE OP WORK I hereby apply for mechanical systems permit and I acknowledge that ihe information
Alterations (f Replacemerrt �lew 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; that this form
Repair Est. Comp. Date does not become a permit until signed by the BUILDING OFFICIAL; ihat the work will be
in accordance with the approved plan in the case of all work which requires review and
Est. Cost $ f�G� -� Building PermR # a proval of plans.
HEATING PERMIT FEE $ a�lo-o7 � � f
STATE SURCHARGE $ .50 A icant's ' natur Date
TOTAL PERMIT FEES $ Receipt # �-�P �3�
Buildi Official's Signature Date
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