HomeMy WebLinkAboutHeating Permit 94-0191 1. Pink - File
� � n 2. Green - City
9
U OF PRIOR LAKE TYPE OF STRUCTURE 3. Yeilow - Conuacror
m 9 DAKOTA STREETS.E. Permit No. �'� "�� Single Family � Two-FamiN Multi-Famiiy
� IOR LAKE, MN 553T2
Commercial Industrial Public Other
E APPLICATION / PERMIT
/ JOB VALUATION FEE
PtD # oZ.�' � �(� �' CS � (i —T1
�� 3 � -` + R fl ���� $p _$1 2% of job value, min. $20.00
Site Address r �OIIQ YC�Q
� /� � f /� $1,001 -$10,000 $20.00 for the first $1,000 plus $1.25 for each additiona)
Lot � Block ,� Addition � �t u.,c ��L�(,Q,�, �Y�L (.T"�X�
- � $f 00.00 or fraction thereof to and including $10,000.
Owner's Name iC11�'�'1 �t��Y1 $10,001 -$50,000 $132.50 for the first $10,000 plus $1.00 for each addi-
Address 1��5� l�lr\UX.� RI� �1►Y� 1t�Y Gl.CC� tional $100.00 or fraction thereof, to and including
Heating Contractor Ron' s Mechanical , Inc $50,000.
Address 1812 East Shakop,ee Avenue Shakopee, MN $50,001 andover $532.50 for the first $50,000 plus $7.50 for each addi-
tional $1,000 or fraction thereof.
Telephone # 4 4 5- 8 5 8 5
The price of your heating permit includes one rough-in and one final inspection.
Furnace Make & Model PE OF SYSTEM
"' `- ��ne.1 at $Q5.00 eBCh.
Warm Air Plants
Model Size Gravity CLOSED DUE TO W�h building r�ermit number before build-
� Conn. Load Mechanical INACTIVjTy g/30/O1
Air Conditioning /I3���
. Fuel Flue Size Vent. System �� � aber of supply and return openings listed
• HEATING OR POWER PLANT per room witn �r��� � r .,. _� ures or additions send floor plan with sup-
Supply Openings 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 Output Special Devices
City HaH business hours are 8 a.m. - 4:30 p.m.
Edr.
Other Devices ALL WORK MUST BE INSPECTED (ROUGH-IN AN FINA )- CALL CITY HALL
Cfm. 447-4230.
TYPE OF WORK I hereby apply for mechanical systems permft 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 acxordance with the approved plan in the case of ali work which requires review and
Est. Cost $ 1`� � Building Permit # � Q�- approval of plans.
HEATWG PERMIT FEE $ ,�t J � .�c� �
STATE SURCHARGE $ .50 A icant Signature Date
TOTAL PERMIT FEES $ � � � Receipt # � Y V —� l �! � �
Building ficial's Signature Date
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