HomeMy WebLinkAboutHeating Permit 94-0047 r
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� pR' TYPE OF STRUCTURE 3. Yellaw - Contracror
., �.� CITY OF PRIOR LAKE
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� m 4629 DAKOTA STREET S.E. Permit No. � �' (. Single Family Two-Family Multi-Family
PRIOR LAKE, MN 55372
Commercial Industrial Public Other
" HEATING APPLICATION / PERMIT •
Date �°7 �—�`� PID # c��'—���—,�Q�=� �OB VALUATION FEE
Site Address `/G iG, �.1�.,.,,�, .,; �/ �� $0 -$1,000 2% of job value, min. $20.00
Lot �<°'Bfock �_ Addition + $1,001 -$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��/�i��-r $10,001 -$50,000 $132.50 for the first $10,000 plus $1.00 for each addi-
Address �p �� ya�c� �i �, f'. tional $100.00 or fraction thereof, to and including
Heating Contractor ,��,,,. �!� � /�-�� $50,000.
Address �/ia �d. �- � /'✓`J _ _ _.,, /1�iV SS�yG� $50,001 and over $532.50 for the first $50,000 plus $7.50 for each addi-
- .+ -, tional $1,000 or fraction thereof.
Telephone # �.�y � �G S�(
The price of your heating permit includes one rough-in and one final inspection.
Furnace Make & Model ?' � Z% TYPE OF SYSTEM Additional inspections will be billed at $25.00 each.
Warm Air Plants �/
Model Size �, G�r? Gravity House Heating Test Record must be submitted with building permit number before build-
Conn. Load Mechanical ing certificate of occupancy will be issued.
Air Conditioning
Fuel �Flue Size 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 Openings f 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 �' �GClr' Output �Y �� � 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. _ i�� „� � ��� >�- 2, 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; 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; that the work will be
�_ in accordance with the approved plan in the case of all work which requires review and
Est. Cost $ 2� `"� � o Building Permit # approv
HEATING PERMIT FEE $ �/.� o�� �� ��� 9�
TATE SURCHARGE $ .50 IicanYs Signature Date
TAL PERMIT FEES $ �%.� `� Receipt #
z- � � -�
. � ' ng Official's Signature Date