HomeMy WebLinkAboutHeating Permit 94-0102 "'p � I�� -- - 1. Pink - File
- > �F PR��� D� LAKE 3. Yellow - Conuacror
� / TYPE OF STRUCTURE
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u �_r, ;. TA ET S.E. permit No. G '� Oz Single Family � Two-Family Muni-Family
' `���KE 55372
Commercial Industriai Public Other
N / PERMIT
Date �- Q- �� �� �� ��a � � JOB VALUATION FEE
Sfte Address �7(0,3� (�i ) j�/d �,e�f� Q��- $0 -$1,000 2% of job value, min. $20.00
Lot � Block � Addition WI �6ws � S�' $1,001 -$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 C. rJ C �/�J�
$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
� E D G W�.�.� �50,000.
Heating Contractor �
Address �EATING & A!R CONDfTlOIVlNG CQ $50,001 and over $532.50 for the first $50,000 plus $7.50 for each addi-
tional $1,000 or fraction thereof.
Telephone # M�NNEAP01,!$, MN 5S4ZQ-28;�{
i permit includes one rough-in and one final inspection.
Furnace Make & Model TYPE OF SYSTEM CLOSED DUE T� a billed at $25.00 each.
Warm Air Plants
Model Size Gravity INACTIVITY 8/30/O 1 must be submitted with building nermit number before build-
Conn. Load Mechanical will be issued.
Air Conditioning
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 Dev' es � ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Cfm.
447-4230.
TYPE OF WORK 1 hereby apply for mechanical systems permR and I acknowledge that the information
Afterations � Replacemertt New Construction 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
Repair Est. Comp. Date � a!�- -l"t �/ does not become a permit until signed by the BUILDING OFFICIAL; that the°work will be
���.J�' in accordance with the approved plan in the case of all work which requires review and
Est. Cost $ ��G13� Building Permit # approval of plans.
HEATING PERMIT FEE $_�b,00 + �-��j_ �t�
STATE SURCHARGE $ .50 Ap icant's Signa e Date
/ 4�2�-94
TOTAL PERMIT FEES $_ O�D �SL� Receipt # �lo � _
uilding Official's Signature Date
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