HomeMy WebLinkAboutMechanical Permit 01-0445
~ ,,'
I~
v~
~
) I. !
i ,-" : f2 1':,......., r
ell f OF PRIOR LAKE Me d)1~EL('
16200 Eagle Creek Av. S.E. Permit No. . ! r ( I
Prior Lake, MN 55372
Model Size ~ ') r-D 0 0
Conn. Load
Fuel h o-tu. V-a... I Flue Size
Supply Openings
Return Openings
Input41): bO 0 Output L./ a ~ 1 f) 0
Edr.
Cfm.
Alterations ')(
TYPE OF STRUCTURE.
1. Pink File
2. Green City
3. Yellow Contractor
Single FamilY, X
-..___.... r
Commercial
Two-Family
Industrial
HEATING APPLICATION I PERMIT
Date Of) j.LL./ 0 I PID # ~S- -~3c. - 6
Site Address t./ / ,30 wi r)dsOn Q Ci J"C/I 6
J . .'
Lot _:d- Block I Add~ion jj:Lvn~ ffJL t1u. dr~
Owner's Name D::th M e.f-z.. G1 e- y-
--
Address _ 4130 W l' ndsoY1Q C,.; V'c.Ae.."
v
Heating Contractor \NoV\~ ~OLL+hS' dt"" H-tq. J-- A Ie. (he.
- ,.. - v '.
Address JoOtC?O tAJes+ \4(o~ Sfr.ee-+/ ~ lOtp
Telephone # Cf 5;} 431- '10'l "I ,A;pp IL Valle- y
AmaYlA.-
Furnace Make & Model Gu V PrO L.I ~
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
~
~
~ $3~.'~
$39.50
Remember to add the State Surcharge on the bottom of this application.
AIR CONDITIONER' UNITS CANNOT
ENCROACH INTO SIDEYARD Sc I DACKS.
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 'X
Air Conditioning_
Vent. System REQUEST FOR INSPECTION
HEATING OR POVl SENT TO HOMEOWNER. NO
Steam RESPONSE - CLOSE FILE
Hot Water 4/2003
Radiation
Special Devices
Other Devices
House Heating Test Record must be submitted with buildina oermit number before build-
ing certificate of occupancy will be issued.
, ,_...... "'.., "'. II ......'')NS REQUIRED, with number of supply and return openings listed per
3r opening. New structures or additions send floor plan with supply
:; shown. HEAT LOSS CALCULATIONS, PAYMENT AND
~Y BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
::>RIOR LAKE, MN 55372.
lours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Fax: (952) 447-4245
Phone: (952) 447-9850
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.
Replacement
TYPE OF WORK
New Construction
~ r<. /))<h-A-~
Applic~'s Signature
Buildin
Repair Est. Comp. Date OS' III J D I
Est. Cost $ /.f t) h {) - Building Permit #
HEATING PERMIT FEE $fIIlIJl r3er.~
STATE SURCHARGE $ .50
TOTAL PERMIT FEES $/JillIfJ 40 - Receipt # .39 58'1
05/IJ/OJ
. Date
J~tf1-() /
Date '