HomeMy WebLinkAboutHeating Permit 94-0290 t. Pink - File
` ��F PR �� �'' TYPE OF STRUCTURE 3. YellaN - C nVacror
�IOR LAKE �[
� DA � STREET S.E. permit No. �! '" 2 �� Single Family �_ Two-Family Mufti-Family
`S�P 2 3 �R , MN 55372
Commercial Industrial Public Other
ATtON / PERMIT
- • . �-��:� � JOS VALUATiON FEE
Date -� . PID #�� - f�J�" �7�— D
Site Address
�? �� d �� F�a� Ci��i'� $0 -$1,000 2% of job value, min. $20.00
$1,001 -$10,000 $20.00 for the first $1,000 plus $1.25 for �ach additional
Lot Block Addition $100.00 or fraction thereof to and including $10,000.
Owner's Name ��� V v..�:$T� + ���� � $10,001 -$50,000 $132.50 for the first $10,000 plus $1.00 tor each addi-
Address 7 1..�`r �'101r- tional $100.00 or fraction thereof, to and including
Heating Contractor ,�DY1 � 5 (� e,.Ct' )Ctyt I Ct�.� ,�p oL • $50,000.
Address �$) v� �QST S►'I(A.K�1�£e.- 1�1�J'1 9� ��OI�P. _ $50,001 and over $532.50 for the first $50,000 plus $7.50 for each addi-
. . tional $1,000 or fraction thereof.
Telephone # �� �' �8'J`
The price of your heating permit includes one rough-in and one final inspection.
Furnace Make & Mode! S it! TYPE OF SYSTEM Additional inspections wili be billed at $25.00 each.
Warm Air Plants � ermit number before build-
� Model Size � L� ,� !�d Gravity House Heatin� T�°• °-- ' R
�Conn. Load Mechanical ing certificate CLOSED DjJE, TO
- Air Conditioning
Fuel iC7. Flue Size Vent. System HEAT CALCi �ACTIVITY g�30���- ' and retum openings listed
HEATING OR POWER PLANT Per room with ns send floor plan with sup-
Supply Openings ply and retw __.,���v�ATIONS, PAYMENT AND
Steam
Return Openings Hot Water APPLICATIOfva nnAY BE MAILED TO THE CITY OF PRIOR LAKE, 4629 Dakota St.
Radiation S.E. Prior Lake, MN. 55372.
Input � l.?' � Output �r�.DdO Special Devices
City Hall business hours are 8 a.m. - 4:30 p.m.
Edr.
Other Devices ALL WORK MUST BE INSPECTED (FtOUGH-IN AND FINAL) - CALL CITY HALL
Cfm. 447-4230.
TYPE OF WORK I fiereby apply for mechanical systems. permit and 1 acknowledge that the information
Afterations ReplacemeM �_ ►Vew 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 4 �0'��9� does not become a permit until signed by the BUILDING OFFICIAL; that the work will be
in accordaace with the approved plan in the case of all work which requires review and
Est. Cost $ ��� Building Permit # approval of plans.
HEATING PERMIT FEE $ ��, .SI� �����_
STATE SURCHARGE $ .50 �cant' Signature _ Date
TOTAL PERMIT FEES $��3.� Receipt # 7� G � r
Buii ng Off'�cial's Signature Date
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