HomeMy WebLinkAboutNo 12310
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HEATING PERMIT
R@C@Ipt Permit Fee :39.50
State Surcharge , .50
TOTAL FEE PAID 4n.~-
Permission is hereby granted to Controlled Air
Building on Lot No. 5 Block 1 Subdivision Dodd P01nte 3rd Addn
Parcel 22-20$62-050-0 I
in theClTY OF LAKEVILLEtobeusedas Hermit to install heating in new construction
This permit is issued on the express condition that the ERECTION -ALTERATION __REPAIRS
~_INSTALLATION MOVING gEMOLITION respects to the. statements certified to in the application for
such permit, and that all work shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota and the State of Minnesota
pertaining to the construction of buildings.
street Address 16074 Excel Way Glenn A. Langord
Director,license and Inspection
GALL FOR INSPECTION - 469-4431 ey ~
i
HEATING, VENTILATION & AIR CONDITIONING PERMIT APPLICATION
CITY OF LAKEVILLE INSPECTION DEPARTMENT
8747 208TH STREET .WEST, P.O. BOX 957
LAKEVILLE, MN 55044
469-4431
r~
DATE : _ ``'j _ ~ ' -
JOB. SITE ADDRESS: (r' ~ LW.. ~ ! ~ PID
LEGAL DESCRIPTION: LOT: BLOCK: SUBDIVISION OR SECTION:
APPLICANT: OWNER OR ONTRACTO_R~~ci~rc~le one)
OWNER OR BUILDER ~ ~ ~ '~'_';,s~t PHONE: ~
STREET ADDRESS: CITY: ZIP: ~~X~
MECHANICAL CONTRACTOR: C~L~ ~ ~ d~CITY iD N0. PHONE: ~~C%
A---- ,
STREET ADDRESS: ,I tY~i~~ ,~a'L`,T?(i CITY: _ ZIP: ;~5~
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NEW CONSTRUCTION OR EXISTING (circle one)
TO INSTALL: HEATING (41): EATING/AIR COND. (42): AIR COND. {43};
FIREPLACE/STOVE (44): GAS PIPING (45): "VENTILATION (46):
REFRIGERATION (47): POWER PLANT (48): FUEL TANK (49):
FOR: RESIDENTIAL: /'COMMERCIAL: INDUSTRIAL: PUBLIC:
JOB COST: i (commercial only)
SYSTEM DESCRIPTION: 1 2 3 4
SYSTEM TYPE:
QUANTITY: ~%L~"`1
MAKE:
MODEL: r'°, ~ ~
~~~~tt=. '
FUEL: i' h ~ ~
FLUE SIZE: _
OUTPUT:
CFM TOTAL:
CFM OUTSIDE:
TONS:
H. POWER:
t`
APPLICANT'S SIGNATURE: w DATE:
HEATING EF. RATES:
Residential: Commercial:
New Construction: $40.00 1% of contract cost, up to $1D,000
($39.50 + ,50 surcharge) and 1/2% over $10,000 + surcharge
Minimum: $20,00 ($19.50 + .50 surcharge (contract valuation x .0005).
Minimum of $24.50 + .50 surcharge
($25.00)
HEATING. VENT. & AIR COND. PERMIT APPLICATION PAGE 2
OFFICE USE
FUEL TYPE: WORK TYPE:
_~-f~l) NATURALGAS ~~1) NEW
(92) ELECTRIC (82) ADDITION
(93) WOOD (83) REPAIR
(94) SOLAR (84) DEMOLISH
(95) PROPANE (85) REPLACE
(96) FUEL OIL (86) ALTER/REMODEL
(87) MOVE
REQUIRED INSPECTIONS:
ROUGH-IN (64)
FINAL (65}
GAS TEST (69)
OTHER (70)
PERMIT FEE:
HEATING PERMIT FEE: $ C.'
SURCHARGE: $ C
OTHER: $
TOTAL: $ ~ ` Ci' C
APPROVED BY: DATE:.,