HomeMy WebLinkAboutMechanical Permit #00-0050
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City
Contractor
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1.
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00.-065D
CITY OF PRIOR LAKE
16200 Eagle Creek Av. S.E. Permit No.
Prior Lake, UN 55372
TYPE OF
Multi-Family
Other
Public
X Two-Family
! .
Industrial
Single Family
Commercial
HEATING APPLICATION I PERMIT
L I' ZS-tJ3Q -""doLJ.-O
~ ie/GoO
($39.50 minimum)
FEB
1 % of job cost
$99.50
$64.50
$39.50
$39.50
$39.50
Industrial, Commercial & Multi-Family
Residential
Residential
Residential
Residential
Residential
Heating & AC
Heating Only
Gas Fireplace
Additions & Alterations
AC Only
Fee Schedule
1ST
Date
Lot 3 Block
Owner's Name
Address
AVE.
ST LOUIS PAR~ MN 55426
Heating Contractor
Address
Remember to add the State Surcharge on the bottom of this application.
your heating permit includes one rough-in and one final inspection.
inspections will be billed at $35.00 each.
:e of
CLOSED DUE TO
INACTIVITY 1/1/03
Telephone #
Furnace Make & Model
building permit number before build-
lal
;eating Test Record must be submitted with
lificate of occupancy will be issued.
Model Size
lilY "'Il:"
J:iEAI CAL' LATI REQUIRED with number of supply and return openings listed per
room with CFM's per opening. New structures or additions send floor plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) -
CALL CITY HALL
HEAnNG OR POWER PLANT
Steam
Hot Water _
Radiation _
Special Devices
Devices
Other
Flue Size
Output
Conn. Load
Supply Openings
Return Openings
Input
Edr.
Fuel
447-4230
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become 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 tequires review and approval of plans.
New Construction
TYPE OF WORK
Replacement
Cfm.
Alterations
Est. Comp. Date
q .O{) Building Permit #
HEATING PERMIT FEE $ V q .50
Repair
Est. Cost $
01
S~
Receipt #
50
$
TOTAL PERMIT FEES $
TYPEC
Warm J
Gravity
Machal
Air Conditioning
Vent. System
STATE SURCHARGE