HomeMy WebLinkAboutHeating Permit 94-0101 /� 2 O� n 2 1. Pink - File
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� PRIOR LAKE TYPE OF STRUCTURE 3. Yetlow - Contractor
� � I��629 OTA STREET S.E. permit No. `��' � �) Single Family Two-Famity Mufti-Family
PR KE, MN 55372
Commercial Industriai Public Other
P LICATION / PERMIT
Date � PID # d`S— ID �—� D�� �OB VALUATION FEE
��'""�/�� $0 -$1,000 2% of job value, min. $20.00
Site Address 3�� ��%�tJ�✓ 1%!� � ..� GV•
Lot Block Addition �Yt�" £ �� $�.�� '$�d.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 /l/�G�d��4
$10,001 -$50,000 $132.50 for the first $10,000 plus $1.00 for each addi-
Address .���!S �.%�d��/ .i��t.f7 �t. �.5.l� tional $100.00 or fraction thereof, to and including
Heating Contractor �t�, �,/�2�� ���� �/��j $50,000.
Address d2���J ✓/�i"a����t=� �- ����,�,� �� $50,001 and over $532.50 for the first $50,000 plus $7.50 for each addi-
tional $1,000 or fraction thereof.
Telephone # C IZ — ✓ Cl �
The price of your heating permit includes one rough-in and one final inspection.
Furnace Make & Model TYPE OF SYSTEM Additiona( inspections will be billed at $25.00 each.
Warm Air Plants
Modsl Size Gravity House Heating Test Record must be submitted with building oermit number before build-
Conn. Load Mechanical _ ing certificate of occupancy will be issued.
Air Conditionirtc -•--T �41_C ULATIONS REQUIRED with number of supply and return openings listed
Fuel Flue Size Vent. System _
CI 'OSED D� T �M's per opening. New structures or additions send floor plan with sup-
Supply Openings HEATING OR INAC1 � locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
Steam TY 8 /30/O1 � MAY BE MAILED TO THE CITY OF PRIOR LAKE, 4629 Dakota St.
Return Openings Hot Water _
Radiation MN. 55372.
Input Output Special Devices
City Nan u��,,.ass 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 permft and I acknowledge that the information
Afterations Replacemer�t 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
Rapair Est. Comp. Date does not become a permit until signed by the BUILDING OFFICIAL; that the work will be
ed in accordance with the approv plan in the case of all work which requires review and
Est. Cost $ r� '� Building Permit # approval of plans.
HEATING PERMIT FEE $ �ZD � � U •/
STATE SURCHARGE $ .50 Appli n's ' nature Date
TOTAL PERMIT FEES $ �O • .� v Receipt # � ��0 � � ��
Buil i g Official's Signature Date
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