HomeMy WebLinkAboutHeating Permit 95-0164 - - �•- r i . . ,-, .m r.
1. Pink - File
� r' i + � '�- - -`� 2. Green - City
. ��F PR��R �� � PRIOR LAKE TYPE OF STRUCTURE 3. Yellow - Conuactor
� OT '$TREET S. E. �I S-( lo`�
� Permit No. Single Family ___�___ Two-Family Mutti-Family
" `� � ���I� „ N 55372
� Commercial Industrial Public Other
ION / PERMIT
Date #� S^ d,3 I— �( 7—(� �OB VALUATION FEE
SfteAddress 5724 FAIR LAWN TRAIL SHORE $0-$1,000 2%ofjobvalue,min.$20.00
Lot ��� $1,001 -$10,000 $20.00 for the first $1,000 plus $1.25 for each additional
Biock Additio $f 00.00 or fraction thereof to and including $10,000.
Owner's Name JAMES LEVY 447-3529
$10,001 -$50,000 $132.50 for the first $10,000 plus $1.00 for each addi-
Address 5 724 FAIR LAWN TRAIL SHORE tional $100.00 or fraction thereof, to and including
$50,000.
Heating Contractor RON' S MECHANICAL , INC .
Address 12011 OLDBRICK 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# 445—$585
/�,,/ The price of your heating permit includes one rough-in and one final inspection.
. f�aa� & Model ��P���L NPE OF SYSTEM Additional inspections will be billed at $25.00 each.
N �� 5 . 5 � � Warm Air Plants — —••-• ►,o � with building permft number before build-
Model Size Gravity C ,
Conn. Load Mechanical DUE TO �
AirConditioninct ��/ �S INACTIVITY 8/30/O1 h number of supply and return openings listed
Fuel Flue Size Vent. System
HEATING OR POWER PLANT structures or additions send floor plan with sup-
Supply Openings �T LOSS CALCULATIONS, PAYMENT AND
Steam "', �
Return Openings Hot Water APPLICATIONS MAY BE MAILtu �v 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 Replacement New Construction above is complete and accurate; ihat 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 ��/ 3�c1 � does not become a permft until signed by the BUILDING OFFICIAL; that the work wili be
O v �� in accordance with the approved plan in the case of all work which requires review and
Est. Cost $ f'� Building Permit # approval of plans. �
HEATING PERMIT FEE $ !A' � f �
STATE SURCHARGE $ .50 g� ppli 's S' e D e
,Z� ��d � `�
TOTAL PERMIT FEES $ O�.S� S� Receipt # ---""�
Buil ing Officiat's Signature Date
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