HomeMy WebLinkAboutMechanical Permit 01-0257
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CITY OF PRIOR LAKE MC . .
16200 Eagle CreekAv. S.E. Permit No.()I-()~7
Prior Lake, MN 55372 .
Date
PID#
Site Address 411 (p It, d de tJ ?on 01 ., Y" OL\ \ .
Lot ::J- Block I Add~ion" kC&, pburl/ f),/da.e. ~
-- '- . / I
Owner's Name Mo..\'" ~ \v\ \ \ \ ClV' c\
Address 4 \, (0 \.\, dc\eh Pond -T V"a ~ I
Heating Contractor Wo~ \e.K So Ll'-ths ,de \.\+tl. ~ Ale I \ nc.. .
v .
Address lotl '30 W. \~ (O+h S{.. Ste. \ 0(0 A-no le \J a \ \e" 551 J-4
. I . ,.
Telephone # ct5;) I 4~ 1- 10tl OJ
Furnace Make & Model
AIR CONDITIONER' UNITS CANNOT
ENCROACH INTO SIDEYARD SETBACKS.
Model Size
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
AirConditioning.Hei I :?+On IOSE~R
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Other Devices
Conn. Load
Fuel Flue Size
Supply Openings
Return Openings
Input Output
Edr.
TYPE OF STRUCTURE,
1. Pink File
2. Green City
3. Yellow Contractor
Single Family X
Commercial
Two-Family
Industrial
Public
Multi-Family
Other
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50 'lJ)O\
<{39.5([l ~ - Z
Remember to add the State Surcharge on the bottom of this application.
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections will be billed at $35.00 each.
House Heating Test Record must be submitted with puildinq oermit number before build-
ing certificate of occupancy will be issued.
HEAT CALCULATIONS REQUIRED with number of supply and return openings listed per
room with CFM's o~.. ')pening. New structures or additions send floor plan with supply
and r~t. .--- - 'own. HEAT LOSS CALCULATIONS, PAYMENT AND
lE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
lR LAKE, MN 55372.
10/03/2001
CLOSED DuB 1'0
IN^C1'l\Tl1''l
are 8 a.m. - 4:30 p.m.
..~SPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Cfm.
TYPE OF WORK
Alterations X
, Replacement
New Construction
Repair
, Est. Comp. Date 0 3 ! ~ 8 ! 0 J
Est. Cost $ J d 00 - Building Permit #
HEATING' PERMIT FEE $ :3 q ~
STATE SURCHARGE $
TOTAL PERMIT FEES $ 40 -
.50
Receipt # <..59 3?!j
Phone: (952)447-9850
Fax: (952)447-4245
I 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 requires review and approval of plans.
~f<.W~
~ Signature
BLf9.ding Offical's Signature
() d J d 8'1 0 I
. Date
(j-3-() J
. Date