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HomeMy WebLinkAboutLA024715 IY VI 20195 HOLYOKE AVE. ®P.O. BOX 957 .PERMIT TYPE: -'~~;~~~Iltw ~'a Lakeville Minnesota 55044-$012 Permit Number: (612) 469-4431 Date Issued: C~~/~0~~ SITE i4®RESS: 1.fi~~f3 GI~Y~T~ t~ I T~~~S T.,,~ ~ ; 1 ~Lz~~~ ; 1 i~~?TST~i~ T~~.I~~ ~0~~~ FS"~~.'~FS ~~~i ADT~ I T I O~ ®ESCRIPTI®IV: 1 HF.~'~~ ~ C 1, ^ ~i~~~ 'ATtI~AL t~AS ]~A~,~; F,~YA?~T ~~~3TJE~, ~~3KAU030~~ ~~UTF'~IT , C~O~ AID C~N~3IT~CII~ING F~7~~ ~'7.~~~'RIC ~'~~K~: ~S~YANT MC#AEI~ ~~~.~~14z~ ~1?T~'t3~' ~Ott~ I I REMA?R~CS: i SEE SUMMARY: ~~se ~e T~t~l Fie , C®NTRAGT®R: - A.~~lic~r~~ OWNER: ~AG~~d A~I9T ~i~~.er,; X~~ C X1.2 ~ I ~~~~,F:~Y ~'~A~' ~~1~~ Ft:.jR W~Ii;~ T~Ik> F'H.~J~'~' I+-~~t3FT~ ~NAT,I, ~F F°F~- ^ ~ { ~ ; ^ A ~ ~#;'t~~~ ~t ~ ?,1 s~i[ ~S ~ ~ r t~:. ~ ~ t A ~ t 31~t,,-~ ' } 3 APF"T ~~'~A.~I1F C;1T~ i"7~;!I~F3t~:(~t.;E~~, AEI} ti;i"3T~~:~~~.; ~~~T?, tai) T1?F 7~f.~s ST~1TF ~~]I~{Ti~:Ptit.:T i ~")i~~:. ~ a~ ISSUED BY: SIGNATUR ~~~~v ` HEATING, VENTILATION & AIR CONDITIONING PERMIT APPLICATION CITY OF LAKEVILLE BUILDING INSPECTION DEPARTMENT 20195 HOLYOKE AVENUE, P.O. BOX 957 LAKEVILLE, MINNESOTA 55044 DATE: g° I~"~1.3 (612) 469-4431 , t~ ~ - ~ JOB SITE ADDRESS : U ~ - i S .L~-, r / LEGAL DESCRIPTION: LOT: ~ BLOCK: SUBDIVISION: L~~s~a-c. ~i4/L L-~~t-F - APPLICANT: OWNER OR ONTRACTOR ~"^~~y``~~/~~{~ (circle one) ~ C~~, OWNER OR BUILDER: ~oITLy.~.p ~y.-vc~5 PHONE: ~ D3y~{ STREET ADDRESS : ~d o / E~-sT,L~,'~ CITY : ~~~OG~~ ZIp : -~i~O~~ MECHANICAL CONTRACTOR: f~f~vaE~ /~TG. 9~ A!-fC CONTR. NO. 7a / PHONE•7'`~d'-`~~'S STREET ADDRESS: 19s~ .S`j/{-i-~JVrtJ~-C `~?p. CITy; ~,q9,~-„J ZIp:..~S~f~,2.~ NEW CONSTRUCTION OR EXISTING (circle one) HEATING (41): HEATING/AIR COND.. (42): ~ AIR COND. (43): FIREPLACE/STOVE (44): GAS PIPING (45): ~ .VENTILATION (46):_a~ REFRIGERATION (47): POWER PLANT (48): FUEL TANK (49): GARAGE HEATER (50): MISCELLANEOUS (55): t ~,~~RESIDENTIAL: ~ COMMERCIAL: INDUSTRIAL: f~ G JOB COST: (TO BE COMPLETED FOR COMMERCIAL JOBS) ~ SYSTEM DESCRIPTION: 1 2 3 4 SYSTEM TYPE: ~a•4~ f G QUANTITY: / / MAKE : ~ 3~;¢.,.~; MODEL : _~3 U SS' .5f? / 03 ~ FUEL : ~ ~ FLUE SIZE: OUTPUT : 3 E~UG~ 3 C~ a~ CFM TOTAL: / Ov CFM OUTSIDE: ~ TONS : ~j- HORSEPOWER: APPLICANT' $ SIGNATURE: a~.._ .DATE: S,3 HEATING FEE RATES: Residential• Commercial• New Construction: .00 1-1 2% of contract cost u to 0 / r $1 an1 (62.50 + .50 surcharge 1% of cost above $10,000 plus surcharge (Surcharge = Contract Cost X .0005) Repairs or Replace: $30.00 Minimum of $30.00 ($29.50 ($29.50 + .50 surcharge) + .50 Surcharge) HEAT LOSS CALCULATIONS NEED TO BE SUBMITTED WITH THIS APPLICATION! Revised 1/1/93 1 `z , ` ~ . , ~ l ~ v 1 _ .1~ y L~~_`! ~ , ~ ~ - ~ ~ ~ - ir C-' j,,... % I _ / ~ ~ ~i i~~~^~~V/?'~? ~l (,mil J n ~ 1 ~ ~'1\ 'r~ ~J ~ , ; f ,X