HomeMy WebLinkAboutHeating Permit 94-0238 �� �' ��l f ��.
t � 1. Pink - File
2. Grcen - Ciry
� pR' � TYPE OF STRUCTURE 3. Yellow - Conuacror
�., CITY OF P IOR LAKE
� AU('j �9�COT �, EET S.E. permit No. �^ 0'�23� Single Family Two-Family Multi-Family
PR10R LA 55372
Commercial Industrial Public Other
°�� A�F��CA ON / PERMIT
Date P � p �._�,Z3 .,. OD,� JOB VALUATION FEE
r � �7� �l, $0 -$1,000 2% of job value, min. $20.00
Ske Address � � 7� U �J !1 �• ��-
Lot Block Addition Ice� . � q�,.�,� �L{ � �. $��001 -$10,000 $20.00 for the first $1,000 plus $1.25 for each additional
�T �, $100.00 or fraction thereof to and including $10,000.
Owner's Name / �� �E �
� � �� $10,001 - $50,000 $132.50 for the first $10,000 plus $1.00 for each addi-
Address � T� tional $100.00 or fraction thereof, to and including
Heating Contractor � � �� ��_ $50,000.
Address ���- /� •�� /�- ��- $50,001 and over ��'" 50 for the first $50,000 plus $7.50 for each addi-
�� r � r/ '�1,000 or fractian thereof.
Telephone # S D D �E T� 1 cludes one rough-in and one final inspection.
Qrrl-2y—
Furnace Make & Model Wt ✓�o�D TYPE OF SYSTEM �
Warm Air Plants
CL v ITY 813��0 �5.0o e�n.
Model Size ��� D�U Gravity �NACT _� omitted with building2ermit number before build-
Conn. Load Mechanical _....upancy will be issued.
Air Conditioning
Fuel ��- S Flue Size Vent. System HEAT CALCULATIONS REQUIRED with number of supply and return openings listed
HEATING OR POWER RLANT per room with CFM's per opening. New structures or additions send floor plan with sup-
Supply Openings •
— - --- - -- - �team
- --- — �
Return Openings Hot Water APPL{CATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 4629 Dakota St.
Input cS Output �r ��� Radiation S.E. Prior Lake, MN. 55372.
Special Devices
City Hall business hours are 8 a.m. - 4:30 p.m.
Edr.
Ot r Devic ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Cfm. y^ , 447-4230,
TYPE OF WORK I hereby apply for mechanical systems permft and I acknowledge that the information
Afterations Replacemertt FVew Construction above is complete and accurate; that the work will be in conformance with the ordi-
, / nances and cades of the city and with the state building/mechanical codes; that this form
Repair Est. Comp. Date �l �'"� `'` does not became 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 $� G � Building Permit # �— a roval of ns.
PP P �� ^
HEATING PERMIT FEE $ �� c� ' � 6r�
STATE SURCHARGE $ .50 plican ' Si ature Date
�" g S " " � l 'T
TOTAL PERMIT FEES $ S/� Receipt # �LZ�
Buildi aficial's Signature Date
'-,��{ .. . , s . �°T�Yt;`.'f..�i..+. . • -. _+..,. r..-� . , .gr-.�3rri
_ ' - ' i �. + . > ,
, a.�.„,,,..,,._, ..�......�. � �,...._ 1s1 :„ °
;�.�ti,�..r.... �.�. �.,� . .�.,
_ ,'.- �' ,, �. � .
. —�,
, _ `�,'' , . �. _ .'� , *-
�,�` � � .
���
. �
�