HomeMy WebLinkAboutHeating Permit 95-0155 � r�� t. Pink - File
'' OF o � r _. TYPE OF STRUCTURE 3. Yellow - C
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� CITY OF PRIOR LAKE
'� 4629 DAKOTA STREET S.E. Permit o. �l Single Family Two-Family Multi-Family
� U � PRIOR LAKE, MN 55372
��� _,_ Commercial Industrial Public Other
HEATING APPLICATION / PERMIT
JOB VALUATION FEE
Date ���0�9,� PID# 25-185-001-0
- $0 -$1,000 2% of job value, min. $20.00
SiteAddress 17190 SUN RAY CIR SW
Lot 1 Block 1 Addition WOODVIELJ FIRST $1�00� -$�0,000 $20.00 for the first $1,000 plus $1.25 for each additional
$100.00 or fraction thereof to and including $10,000.
Owner's Name PATRICK & SUZANNE WALL
$10,001 -$50,000 $132.50 for the first $10,000 plus $1.00 for each addi-
Address 17190 SUN RAY CIR SW tional $100.00 or fraction thereof, to and including
Heating Contractor RON' S MECHANICAL, INC . $50,000.
Address 12011 OLD BRICK YARD ROAD $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 4 5- 8 5 8 5
The price of your heating permit includes one rough-in and one final inspection.
Furnace Make & Model TYPE OF SYSTEM AddRional inspections will be billed at $25.00 each.
• Warm Air Plants
AAodel Size Gravity House Heating Test Record must be submitted with building �ermit number before build-
Conn. Load Mechanical ing certificate of occupancy will be issued.
Air Conditioning _� �N S
F'uel Flue Size Vent. System HEAT CALCULATIONS REQUIB�D_ 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 ply and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AWD
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 OF WORK I hereby apply for mechanical systems permit and I acknowledge that the information
Afterations �/ Replacemerrt New 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 �/G��/��` does not become a permit until signed by the BUILDING OFFICIAL; that the work will be
__________ in acxordance with the approved plan in the case of all work which requires �eview and
Est. Cost $���✓ �� Building Permit # ap roval of plans.
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HEATING PERMIT FEE $ r �-7 • a v
STATE SURCHARGE $ .50 icanYs Signatu�� D
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TOTAL PERMIT FEES $ Receipt # ,�L37� -
� � Building icial's Signature Date