HomeMy WebLinkAboutHeating Permit 94-0166 -- A L5 ��� v� 1. Pink - Fiie
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pRIOR ��C OF PRIOR LAKE TYPE OF STRUCTURE 3. Yellow - Conoractar
m DAKOTA STREET S.E. permit No. a 4- �(v�• Single Family Two-Famity Multi-Family
OR LAKE, MN 55372
Commercial Industrial Pubiic Other
APPLICATION / PERMIT
Date
5l' 02 � PID # ��" /''1�' �- ��(�� � JOB VALUATlON FEE
��� s ..����� $0 -$1,000 2% of job value, min. $20.00
Site Address ��q C,
� $1,001 -$10,000 $20.00 for the first $1,000 plus $1.25 for each additional
Lot Block Addition $100.00 or fraction thereof to and including $10,000.
Owner's Name �'c'� �Y I �
('� $10,001 -$50,000 $132.50 for the first $10,000 plus $1.00 for each addi-
Address 'J��i� �j'1Gt,Y1 YLOYI �Y2'�l,t � 9'('1 �Cc.,� tional $100.00 or fraction thereof, to and including
Heating Contractor Ron' s Mechanica_l , Inc . $50,000.
Address 1812 East Shakopee Avenue S�a' $532.50 for the first $50,000 plus $7.50 for each addi-
CLOSED DUE Tp tional �i,000 or traction thereof.
Telephone # 44 5--� 5 8 5 INACTIVITY 8/30/O 1 eating permii includes one rough-in and one final inspection.
Furnace Make & Model TYPE OF SYSTEM > will be billed at $25.00 each.
Warm Air Plants
Model Size Gravity House Heating Test Record must be submitied with building nermit number before build-
f Conn. Load Mechanical ing certificate of occupancy will be issued.
� Air Conditioning l�� �
� Fuel Flue Size Vent. System � HFAT CALCULA710NS REQUIRED with number of supply and return openings listed
F HEATING OR POWER PLANT Per room with CFM's per opening. IVew structures or additions send floor plan with sup-
Supply Openings ply and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AIVD
Steam
Return Openings Hot Water APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR L.AKE, 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 HALI
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; 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 beoome a permit until signed by the BUILDING OFFICIAL; that the work will be
in �cordance with the approved plan in the case of all work which requires review and
Est. Cost $���U• � Build'mg Permit # approval of plans.
HEATING PERMIT FEE $ O� �/d� �����
STATE SURCHARGE $ .50 Appli 's S nature Date
TOTAL PERMIT FEES $ o�J�. � Receipt # 2 �b 0 d ��� � 4
' ing Official's Signatur Date
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