HomeMy WebLinkAboutMechanical Permit 01-0416
File
City
Contractor
1. Pink
2. Green
3. Yellow
TYPE OF STRUCTURE
Jh
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No
Prior Lake, MN 55372
3-
Multi-Family
Other
Two-Family
Industrial
x
Single Family
Commercial
HEATING APPLICATION I PERMIT
'5 - (!)c;q -00 3-D
Public
PID#
05
Date
Fee Schedule
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
~
Industrial, Commercial & Multi-Family
Residential
Residential
Residential
Residential
Residential
Heating & AC
Heating Only
Gas Fireplace
Additions & Alterations
AC Only
Block
Owner's Name
~o
Site Address
i
Address
Heating
Lot
5151 ~y
Address
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.
Remember to add
AIR CONDITIONER. UNITS CANNOT
ENCROACH INTO SIDEYARD SETBACKS.
Furnace Make & Model
House Heating Test Record must be submitted
ing certificate of occupancy will be issued.
Model Size
Conn. Load
with building wmni1 number before buiid-
tlEAI REQUIRED with number of supply and return openings listed per
1']L/ room with CFM's per opening. New structures or additions send floor plan with supply
. and return IOI'~&:- ,own. HEAT LOSS CALCULATIONS, PAYMENT AND
It ,..-. lE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
)R LAKE, MN 55372.
are 8 a.m. - 4:30 p.m.
lSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Phone: (952) 447-9850 447-4245
(952)
I hereby apply for a mechanical systems permit and 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.
10/03/2001
CLOSED DuB TO
INj\C'Tl\Tl'T~
Fax:
New Construction
HEATING OR POWER PLANT
Steam
Hot Water _
Radiation _
Special Devices
Other Devices
Flue Size
Output
TYPE OF WORK
><
Comp. Date
Fuel
Supply Openings
Edr
Cfm.
Replacement
Est
Return Openings
Input
Alterations
Repair
((. IJJ~~
Applicant's Signature
,~
ffical's Signature
Building Permit #
50
=--
a \ 00 .--
HEATING PERMIT FEE $
TYPE OF SYSTEM
Warm Air Plants
Gravity _
Mechanical _
Air Conditioni
Vent. System
Cost $
Est.
Receipt #
.50
40-
$
TOTAL PERMIT FEES $
STATE SURCHARGE