HomeMy WebLinkAboutMechanical Permit 01-0370
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File
City
Contractor
1. Pink
2. Green
3. Yellow
Multi-Family
Other
Two-Family
')(
Industrial
Single Family
Commercial
Public
Permit
CITY OF PRIOR LAKE
4629 DAKOTA STREET S.E.
PRIOR LAKE, MN 55372
HEATING APPLICATION I PERMIT
FEE
JOB VALUATION
PID#
Date
2% of job value, min. $20.00
$20.00 for the first $1,000 plus $1.25 for each additional
$100.00 or fraction thereof to and including $10,000.
$1,000
$10,000
$0
$1,001
Site Address
.
l
IYJ
Lot
for the first $10,000 plus $1.00 for each addi-
00.00 or fraction thereof. to and including
$532.50 for the first $50,000 plus $7.50 for each addi-
tional $1.000 or fraction thereof.
$132.50
tional $1
$50,000.
$10,001 - $50,000
10
d" t~1 '=6'1
0" 19
$50,001 and over
L5c
Owner's Name
Heating Contractor
Address
Address
final inspection
before build-
rough-In and one
price of your heating permit includes one
mal inspections will be billed at $25.00 each.
be submitted with
issued.
Record must
be
Heating Test
:ificate of occupancy wi
The
~[\
Telephone #
Conn. Load
Fuel U/OO~ Flue Size
Model Size
with number of supply and return openings listed
New structures or additions send floor plan with sup-
HEAT LOSS CALCULATIONS. PAYMENT AND
to I L
roOm with CFM's per opening.
locations shown.
-,",I.
HEAT
Steam
Hot Wate
Radiation
Special Devices
Supply Openings
Return Openings
Input
CALL CITY HALL
4:30 p.m
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL)
447-4230.
City Hall business hours are 8 a.m.
Other Devices
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Output
Edr.
I hereby apply for mechanical systems permit and I acknowledge that the information
above is complete and accurate; that the work will be in conformance with the ordi-
nances 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
~Plan
.'X
New Construction
Comp. Date
Building Permit #
50
TYPE OF SYSTEM
:r~vm Air PI~"'- WITH SF #/
Mect CLOSED T"ll\JfITDO
Air<A BUILDING PElUV~ Ct
Vent. (0 't; \
t'GI
ply and return
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 4629 Dakota St
S.E. Prior Lake, MN. 55372.
TYPE OF WORK
Replacement
Est.
Cfm.
Alterations
Repair
Est. Cost $
Receipt
.50
HEATING PERMIT FEE $
$
TOTAL PERMIT FEES $
STATE SURCHARGE