HomeMy WebLinkAboutHeating Permit 96-0255 �
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�� �F PRIp�,` CITY OF PRIOR LAKE ,�,� � � 3 Y� -�,�
� �� 5 TYPE OF STRUCTURE
� �„ 16200 Eagle Creek Av S.E. Permk No. ��
Prior Lake, MN 55372 ` 6��'� /
�ingle Family TwaFamily Mufti-Family
HEATING APPLICATION / PERMIT ^—��
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� Commercial Industrial Pubiic Other
Date "'J - / �- �' �o PID � o����rs S • � ��' � " . � - -- - -------° _
Site Address S? 6r'� f�,(,✓O c� �'f (` t•/U �• Fee Schedule
Lot � Block Addition � � n� � Industrial, Commercial & Multi-Family 1% of job cost ($39.50 minimum)
Owner's Name LU.G!_ h�n 1/Gdl l�GlS Residential, Heating & AC $99.50
Residential, Heating Only $64.50
Address �U �d E>�6�1�n c� /�-(J�.2 . N•C . Residential, Gas Freplace $39.50
Residential, Additions & Alterations 39.50
Heating Contractor ���h �l`S SOU. �`tSlc�.e. ��f���.�/1C• Residential, AC Only $39.50
Address �� 3 � r�v /�S � S� ��DD�P_ ��ts/� A��-SS/
Y 3� _?v Gg Remember to add the State Surcharge on the bottom of this application.
Telephone # 7
Furnace Make & Model TYPE OF SYSTEM The price of your heating permit includes one rough-in and one final inspection.
Warm Air Plants
Model Size A . .... _, -_-_-�._-- ...:�� � �;���+ �+ ��� nn each.
Gravity
Mechanical CLOSED DUE TO
Conn. Load Air Condition 1if/KO�-e, ��`r�c� i� rith buildina mi number before build-
Fuel Flue Size Vent, System INACTIVITY 8/30/Ol
HEATING OR POWER PLANT � r of supply and return openings listed per
Supply Openings r� �r additions send floor plan with supply
Steam a�... ......... .____.___ _ ULATIONS, PAYMENT AND
Return Openings Hot Water APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
Radiation CREEK AVE. S.E. PRIOR LAKE, MN 55372.
Input Output Special Devices
Ciry 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 a mechanical systems permit and I acknowledge that the
Afterations �_ ReplacemeM New Construction information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
Repair Est. Comp. Date �� /�- 9� codes; that this form does not become a permit until signed by the BUILDING
//` OFFICIAL; that the work will be in accordance with the approved plan in the
Est. Cost $�[�.5� "� Building Permit #.,�-!� ( -y75 � case of all work which requires review and approval of plans.
HEATING PERMIT FEE $ 3 I► SO ������(�,Gryl���,(�(/�-� '7��5' I�
STATE SURCHARGE $ .50 pplicanYs Si nature Date
TOTAL PERMIT FEES $ �� 0� Recei t# ��y S � � V! g ��
p � uildin ical s Signature Date