HomeMy WebLinkAboutMechanical Permit 01-0317
Date 0 ~ I \l 0'
.
Lot
Block,
Furnace Make & Model
Model Size
Conn. Load
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit N
Prior Lake, MN 55372
AIR CONDITIONER' UNITS CANNOT
ENCROACH INTO SIDEYARD Sc I aACKS.
TYPE OF STRUCTUH~
Single Family
Commercial
x
Two-Family
Industrial
HEATING APPLICATION I PERMI
PID # ~S -- o{f'J-- ()f);-()
Site Address \ 5'14 0 A rctl G Cl Y'(, Je ~ 0 v-+---h
r' .
Addit~+- 5 ~L61J;?J~
Owner's Name s\"o '\J W y- 0 be I
f
Address \ 5114 0 A Y'c"tf G CJ Y' c( e..- No v..d-h
Heating Contractor W 0 h \.,a v<; 5ou+l1tiJe i-\--K. t- Pc t c ( I n c .
v
Address foq50 W. \4l.P ~ St.. S-te. \00, A t?t:>~ Va \ \.e" '561J"4
. .. . I"
Telephone # c?l5d I Vl31-1o&i~
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
Public
Multi-Family .
Other
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
~
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.
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning.He i Lf fon I o5-el~e.
Vent. System moderl N A-WZY
HEATING OR POWER PL6NT
Steam 3/2001
Hot Water . 1 % UE TO
Radiation CLOSED D
Special Devices ' INACTIVITY
Other Devices
Fuel Flue Size
Supply Openings
Return Openings
Input Output
Edr.
Cfm.
Alterations
Repair
TYPE OF WORK
Replacement X New Construction
Est. Comp. Date D If Iii I 0 I
Est. Cost $ I ~O 0 .- Building Permit #
HEATING PERMIT FEE $ 39. 'SJ2
.50
STATE SURCHARGE $
TOTAL PERMIT FEES $ '-10'-
Rece~ 0 q 31 ;;2"
House Heating Test Record must be submitted with buildinq oermit number before build-
ing certificate of occupancy will be issued.
J:tEAI CALCULATION$ .Bf:aUIRED with number of supply and return openings listed per
room with CFM's per oru'~"'ing. New structures or additions send floor plan with supply
anti p,.A.. . l. HEAT LOSS CALCULATIONS, PAYMENT AND
'AILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
.AKE, MN 55372.
8 a.m. - 4:30 p.m.
_' ECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Phone: (952) 447-9850
Fax: (952) 447-4245
,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.
~~.w~
Applicant's Signature
OC--
BUildiVffical's Signature
oU//lIOI
V/!~.i~ r
'7i ~te I