HomeMy WebLinkAboutHeating Permit 95-0231 �oC rY , ��{ �� , - -"- � - - t. Pink - File
� � �r� ' , ; 2. Green - Ciry
� �� C�i"� Q�F,PRIOR LAKE
�� ;� / TYPE OF STRUCTURE 3. Yellow - Convactor
� 9 �' �� Q 9' pTA STREET S.E. Permit No. ��' � Singie Family �/ Two-Family Mufti-Family
�RI KE, MN 55372
Commercial Industrial Public Other
ICATION / PERMIT
Date � PID # v�S - 00 � D JOB VALUATION FEE
'/ � �� $0 -$1,000 2% of job value, min. $20.00
Site Address / �S -r !� rl' / �� �' / � �
Lot T Block Addition �d,�� ,„.r2 1� � r , $�,001 -$10,000 $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 ,�� �� P r
$10,001 -$50,000 $132.50 for the first $10,000 plus $1.00 for each addi-
Address �.��.P� tional $100.00 or fraction thereof, to and including
Heating Contractor ( $50,000.
Address HEAtING � AIR C(lN(lt r rn $50,001 and over $532.50 for ihe first $50,000 plus $7.50 for each addi-
TIOMlN -, tional $1,000 or fraction thereof.
8910 4UEhTWORTH AVE. S0.
Telephone # Nfl
&1•900 The price of your heating permit includes one rough-in and one final inspection.
Furnace Make & Model �TYPE OF SYSTEM. Additional inspections will be billed at $25.00 each.
" Warm Air Plants ��
Model Size 'r.�.f�ab Gravity House Heating Test Rewrd must be submitted with building permit number before build-
.Conn. Load Mechanical _ t/ ing certificate of occupancy will be issued.
Air Conditioning � 'T�D71 ���v�'
Fuel Flue Size �o t � Vent. System HEAT CALCULATIONS REQUIRED 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 penings Steam ply and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
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 �,�'�ao 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 FINALj - CALL CITY HALL
Cfm. �,{� //�LY
447-4230.
TYPE OF WORK I hereby apply for mechanical systei tion
� / above is complete and accurate; tn CLOSED DUE TO �rdi-
Alterations Replacemertt P/ {Vew Construction nances and codes of the city and witt prm
Repair Est. Comp. Date �D el7-�t..s does not become a permit until signe� �ACTIVITY S�3O�O 1 J be
,� in accordance with the approved plai ,and
Est. Cost $_ �ot � Building Permit # "'�� approval of plans.
HEATING PERMIT FEE $ �'�,�IS 7 �j
STATE SURCHARGE $ .50 Appli Ys Sig ure Date
TOTAL PERMIT FEES $ Receipt # �,�1, ld - 3
B' ing Official's Signature Date
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