HomeMy WebLinkAboutHeating Permit 94-0001 �. _ � __--__.—,,,._�
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'�- — - - t. Pink - File
' � G �! � ;,, ? ' • ` 2: Green - City
�I � OF PRIOR LAKE ) TYPE OF STRUCTURE 3. Yeflow - Contractor
� 9 DAKOTA STREET S.E. permit No. � y Single Family � Two-Family Multi-Family
IOR LAKE, MN 55372
Commercial Industrial Public Other
�� G'�APPLICATION / PERMIT
` � -� •k"��'�'���`'" � JOB VALUATION FEE
� l�ate � PID # e�� — ��l `°�/G7 - �
' y� � $0 -$1,000 2% of job value, min. $20.00
Site Ad ress � � l�
�t� 1�1( $1,001 -$10,000 $20.00 for the first $1,000 plus $1.25 far each additionai
Lot Block Addition b-t..�. $100.00 or fraction thereof to and including $10,000.
Owner's Name �l J}1 � �2 Q�Y1 $10,001 -$50,000 $132.50 for the first $10,000 plus $1.00 for each addi-
Address � � " � �`" �� tional $100.00 or fraction thereof, to and including
Heating Contractor �/�` ` $50,000.
Address �3gS�} I,l� � I� � t Lr-l�— �� ,3�j , $50,001 and over $532.50 for the first $50,000 plus $7.50 for each addi-
tional $1,000 or fraction thereof.
Telephone # ��1� ` �7S �
�� 4 The price of your heating permit includes one rough-in and one final inspection.
Furnace Mak & lylo�le �}'I,P�I �(� TYPE OF SYSTEM Additional inspections will be billed at $25.00 each.
Warm Air Plants
Model Size � Graviry House Heating Test Record must be submitted with building �ermit number before build-
Conn. Load Mechanical ing certificate of occupancy will be issued.
Air Gonditioning
Fuel Flue Size Vent. System �FAT CALCULATIONS REQU{RED with number of supply and return openings listed
HEATING OR POWER PLANT Per room with CFM's per opening. New structures or additions send floor plan with sup-
Supply Openings ply and return focations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
Steam
Return Openings Hot Water APPLICATIONS MAY BE MAILED TO THE GITY OF PRIOR LAKE, 4629 Dakota St.
Radiation S.E. Prior Lake, MN. 55372.
Input Output Special Devices
City Hall business hours are 8 a.m. - 4:30 p.m.
Edr.
Other Devices ��sa. �/�PIPc� ALL WORK MUST BE INSPECTED (ROUGH-{N AND FINAL) - CALL C1TY HALL
�m. 447-4230. �
TYPE OP WORK �/ I hereby apply for mechanica! systems permit and I acknow{edge that the information
Alterations Replacemerrt New.Construction �� above is camplete and axurate; that the work will be in conformance with the ordi-
nances and codes of the city and with the state buildinglmechanical codes; that this form
Repair Es� Comp. Date �� � daes not become a permit untif signed by the BUILD{NG OFFICIAL; that the work will be
E � �� $ i��� � in accordance with the approved plan in the case of all work which requires review and
� � Building Permit # a roval of ns.
HEATING PERMIT FEE $ �a�3 � Z� f �� '� �
STATE SURCHARGE $ .50 pplican Signature Date
TOTAL PERMIT FEES $ �I Receipt # ��T� � � / �� (�
Building Official's Signature Date
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