HomeMy WebLinkAboutHeating Permit 94-0200 O�� 1. Pink - File
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� � O F P R I O R L A K E � T Y P E O F S T R U C T U RE
m DAKOTA STREET S.E permit No. 9'y � 2C0 Single Family Two-Family . Multi-Family
IOR LAKE, MN 55372
Commercial Industrial Public Other
TIN APPLICATION / PERMIT
i � �/� �/ � JOB VALUATION FEE
c�te � PID# — o� I/3 —/
Sfte Address � � � (,�p "�' � $0 - $1,000 2% of job value, min. $20.00
Lot 1� Block � Addition � $���� -$10,000 $20.00 for the first $1,000 plus $1.25 for each additional
$100.00 or fraction thereof to and including $10,000.
Owner's Name __'G►�OYI �l�l. A I� $10,001 -$50,000 $132.50 for the first $10,000 plus $1.00 for each addi-
Address �� �� (.cr�l1S� f�7U2Y1L�2 � tional $100.00 or fraction thereof, to and including
$50,000.
Heating Contractor Ron' s Mechanical , Inc .
Address 1812 East Shako�ee Av�nt�e S���'.onee rqn $50,001 andover $532.50 for the first $50,000 plus $7.50 for each addi-
fl tional $1,000 or fraction thereof.
Telephone # 44 5— g 5 8 5 CLVSED DUE TO �ncludes one rough-in and one final inspection.
" Furnace Make & Model TYPE OF SYSTEM at $25.00 each.
Warm Air Plants I N A C T I VITY 8/30/O l
� Model Size Gravity e submitted with building permit number before build-
Conn. Load Mechanical _ ssued.
Air Conditioning � � 70�, _
Fuel Flue Size Vent. System HEAT CALCULATIONS REQUIRED 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 locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
Steam
Return Openings Hot Water APPLICATIONS MAY BE MAILED TO THE CITY 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 ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Cfm. 447-4230.
TYPE OF WORK I hereby apply for mechanical systems permit and 1 acknowledge that the information
Afterations � Replacemertt New Construction above is complete and accurate; that the work will be in conformance wfth the ordi-
nances and codes of the cfty and with the state building/mechanical codes; that this form
Repair Est. Comp. Date does not become a permit uniil 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
Est. Cost $ �?��(�� OJ Building Per it # approval of plans.
HEATING PERMIT FEE $ a✓�'-� � ��� I y
STATE SURCHARGE $ .50 pli Ys S' nature Date
P .�� 79 7—� �-2 �
TOTAL PERMIT FEES $ as �� Recei t# � Building ficial's Signature Date
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