HomeMy WebLinkAboutNo 10068 d,° l Q ® ~'-'brim r~~ 2.3
.City of Lakeville
Permit.
HEATING PERMIT Permit Fee.......... ,
~ Receipt Stote 5urchaege .50
TOTAL FEB PAID'. lh . Qr7
Farmin~?ton Pltnb~;. ~ c'r,s=,. j .t:larer~cQ ''ata_.a~f
Permission is hereby granted to
Building on Lot. No. Block - Subdivision ~'~~t SeC• ~`~''TGmll
Parcel ~6?_2-!~290~=i?1n-?9 , Plat
in the CITY OF LAKEVILLE to be used as Permit to replace heat~n~ Gystern.
This permit is issued on the express condition that the -ERECTION -=ALTERATION -REPAIRS
-ENLARGEMENT -MOVING -DEMOLITION respects Yo .the statements certified to in the application for
such permit, and that. ail work shall be done in accordancewifh the Ordinance of LAKEVILLE, Minnesota and the`State
~ of Minnesota pertaining to the construction of buildings.
Street Address 2017 ~odrl blvd. Tenn A. Lan~orc~
Director, Liaenst and Insp~etion
Attention is particularly called to the cutting. up of streets, making main sewer Y ,;y ~ r~
connections, driveways andcurbs.ObtainpermitforsuchconstructionfromtheClTY 13 ~'-~,/Y,~,,~
OF LAKEVILLE. Inspection DepartmenYNOt Responsible Eor Any Damages to Public-
utihcies: Sin Miller < Rldg. Inspect".
CITY OF LAKEVILLE
BUILDING INSPECTION DEPARTMENT - 469-4931
APPLICATION FOR IiEATIPIG PERMIT
Site Alter Repair
Address Lot Block Addition Install Repair
MAKE L ~ ~ ~ TYPE OF SYSTEM
SIZE ~ " Warm Air Plants
CONN. LOAD Gravity _
FUEL ~ ~~h`_ ~ Mechanical
FLUE DIA.
Air Conditioning
SUPPLY OPENINGS Yent System
RETURN pPENINGS Heating or Power Plant
INPUT ~~r G'C~C~
Steam
OUTPUT ~ L>. Ste'
Hot Water
EDR Radiation
CFh1 K~~
Special Devices c~ ['.fG. ~ ~f'~'"
Other Devices
Plan No. Date
Est. Comp. Dote Est. Cost Heating Permit Fee
Gas Piping Permit Fee
Tofal Permit Fees
f'
Owner's Nome ~ ~ ~ Z ~ ~
f a
Address ~ ~ C~~ ~ l~ ~
Heating Contractor ~ ~ FCC r"/~
f,,
Address r° ~ ~
Heating, Air Conditioning, Ventilation & Refrigeration Permit Fee for single family residence in-
stallation _ _ _ _ _ _ _ $
Alteration or Repair Min. Fee__________________________________________$
Non Residential Fee shall be computed at 1 % of the contract _ _ _
Gos Piping Fee for each installation______________________________________$
Send application and heat loss calculation with check for Permits to:
CITY OF LAKEVRLE
Lakeville, Minn. 55044