HomeMy WebLinkAboutMechanical Permit 01-0292
~~) HEATING APPLICATION I PERMIT
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1. Pink File
2. Green City
3. Yellow Contractor
CITY OF PRIOR LAKE Me (J.-
16200 Eagle Creek Av. S.E. Permit No. ,
Prior Lake, MN 55372
Site Address 3..5.4.5 T SLAN.n V T F.W C T R CL F. NW
lot d- Block ( Addition ~ ~ ~ ~l1xmCLIYU .};' ~
vV
Date
TYPE OF STRUCTURE
PIO, ~5~, ~ "'OD~-O
Single Family )(
Commercial
Public
Multi-Family
Other
Two-Family
Industrial
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
$39.50
Owner's Name DARL ENE LANGE
Address .3...5.4.5 T SLA ND V I EW C I R CL E NW
Heating Contractor RON'S MECHANICAL, INC.
Address
12010 OLD BRICK YD RO
Telephone' 952/445-8585
Furnace Make & Model ~~
Model Size ~-:..- m4 -100
Conn. load
Fuel ->> G
_Flue Size
Supply Openings
Return Openings
Input I~{t){) Output 'gD.t::t::t:)
Edr.
Cfm.
Remember to add the State Surcharge on the bottom of this application.
AIR CONDITIONER' UNITS CANNOT
ENCROACH INTO SIDEYARD SETBACKS.
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections will be billed at $35.00 each.
TVD~ n~ ~V~T~U
CLOSED WITH BLDG PERMIT
101-1215 ON-1/15/02
House Heating Test Record must be submitted with building permit numbe~ 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 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
nt:AIIN\j UH PUWEFI PLANT
Steam
Hot Water
Radiation
Special Devices
Other Devices
Phone: (952) 447-9850
Fax: (952) 447-4245
Alterations
TYPE OF WORK
Replacement ^ New Construction
L. -24-0\
Repair
Est. Comp. Date
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Building Permit ,
3=l.5D
Est. Cost $
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
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 ~ ~~~nd approval of Pla4_ ~ -0 /
- A. ... .~ pplliiccaarn~ Signature . , Date
~~ LI-/~-o /
eYilding Offical's Signature Date
.50
L\D.OO ReceiPt,&:,Q3s1