HomeMy WebLinkAboutPermit 4747B11
APPLICATION FOR MECHANICAL PERMIT
SCOTT COUNTY, MINNESOTA
Township/City -6L
Permit number ~.}'S- 11.
Receipt numberc::::J I bdf3
- - - - - - - - - - - - APPLICANT FILL OUT INFORMATION BELOW: - - - - - - - - - - --
Project Address 1 fi 4 7 7 .H)10 1'r, T Ul-" l' n
(Leave blank if address has not been assigned)
Twp/City q;nRr,,,,,,,
City
State
Zip
Applicant RON 'S MECHANl CA1.. TN!'.
Address
Phone (Home)
(Work)
Owne~ (if other than Applicant) T.QJ:~_5r"RKET,<::()N
City
Phone (Home)
State
Zip
(Work)6.5.lJ?? c;_ ,fiat
Address 20c.CC1 FlITRT a",~) au
City P'OTO'O T i\U'1I State 1'11\
Zip 55372
Contractor Name RON'S MECHANTCAL, INC. Phone (Home)
(Work) qC;?W'i-R",A5
Address 17.010 ()T,n i'lRT('J( vlUU' 1'n
CITy C::i-:r-aU'"nt::'C't:"
State Ml\)
Zip " " ~ 7-9-..
Project Legal Desc. Parcel No.
Section _ Lot _ Block _ Subdivision Name
CHECK APPROPRIATE ITEMS BELOW
BUILDING TYPE: Residential )( Commercial Other
New Construction _ Alteration _ Replacement X Addftion _ Woodstove Other
FUEL TYPE: Natural Gas Fuel Oil_ Liquefied Petroleum X. Wood _ Other
FORCED AIR FURNACE AIR CONDITIONER
MAKE: \ 0 'V\ no\!
BTU'S/TONS:f.I1l00.00U
VENT SIZE:
*1 ton equals 12,000 BTU's
Round total BTU's of the
TOTAL DESIGN HEAT LOAD
BTU'S
FLUE TYPE
furnace & A.C. up to the
next 1 0,000 BTU level.
LIST IN DETAIL TYPE OF WORK BEING PERFORMED
I vL <rtn II \ l\C '(p n\OtO ~ -+u.vV\CLLP
--
Total value of work performed,.
'd-\DO
I hereby agree that the work for which this permit Is issued shall be performed according to the approved plans and
specifications, the applicable County/City Ordinances and the Minnesota State Mechanical and Building Codes.
Applicant Signature ~ ~ ~~ Date 1\ . 'V.I. 00
- - - - - - - - - - - - - - - COUNTY BUILDING USE ONLY - - - - - - - - - - - - - --
REQUIRED INSPECTIONS: Rough.in and gas piping air test: yes _ no _ Orsat and final; yes _ no
Other
Approved _ Denied
By Building Official subject to existing regulations and the following conditions:
SIGNATUR~
Date
ADDITIONAL COMMENTS:
RECEIVED
DEe 0 4 2000
FEES: Permit
Plan Check
30.00
State Surcharge
,so
SCOTT COIIIlIlWi!lLLlG fIllSI' DEPT
TOTAL FEE
30. '50
06600-2821 (4-91 500)
White. County Yellow - Interoffice Pink - Applicant