HomeMy WebLinkAboutNo 12283
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April 29 , 87
_ 12~$~ City of Lakeville- ,s-
HEATING PERMIT
& f~ @C21 pt ' Permit Fee .39.50
State Surcharge .50
TOTAL fEE PAID . , 40:00
Controlled Air
Permission is hereby granted to
Building on Lot No. 5 Block 12 Subdivision DOrinSytS Velley Fark 8th`
Parcel22-2117 7-050-12
in the CITY of LAICEVILLE to be used as permit to install heating in new. construction
This permit is issued on the express condition that the ERECTION ALTERATION ~_REPAIRS
X INSTALLATION MOVING __~EMOLITION respects to the statements certified to in the. application for
such .permit, and that all work shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota and the State of Minnesota
pertaining to3he constructYon of buildings.
street Address 16090 Fair$reen Ave Glenn A. La.ngord
Director, License and Inspection
i
CALL FOR INSPECTION - 469-4431 By C r " ~ F
,
_
HEATING. VENTILATION & AIR CONDITIONING PERMIT APPLICATION
CITY OF LAKEVILLE
INSPECTION DEPARTMENT
8747 208TH STREET WEST
~ P.O. BOX 957
LAKEVILLE, MN 55044
469-4431
DATE: '.a~_ -
JOB SITE ADDRESS: I L~C1C~ ~ct c~ ~~n PID
LEGAL DESCRIPTION: LOT:. ~ BLOCK:~'~ SUBDIVISION OR SECTION: ~ Q Y1 ~ ~
_
APPLICANT: _OWNER CONTRACTORS (circle one) v
OWNER OR BUILDER -~i;~~? ~~~;(1~~,~1' PHONE: ~~pCf -C~C~~~
f(1~
STREET ADDRESS: ,r`~, ~ 'f' CX.cx_~ ~ C' CITY: ~ ~ ~ ZIP: C~~,
MECHANICAL CONTRACTOR: v ~ ~(Q ~~E;fCITY ID N0~ PHONE:
STREET ADDRESS; ~ ; ~ e I CITY: ~ ZIP: ~
L NEW CONSTRUCTI, OR EXISTING (circle one)
TO INSTALL: HEATING (41): i_.,.~'YHEATING/AIR COND. (42); AIR COND. (43):
FIREPLACE/STOVE (44); GAS PIPING (45): ~ ENTILATION (46): ~
REFRIGERATION (47): POWER PLANT (48): FUEL TANK (49):
FOR: RESIDENTIAL: COMMERCIAL: INDUSTRIAL: PUBLIC:
JOB COST• (commercial only)
SYSTEM DESCRIPTION: 1 2 3 4
SYSTEM TYPE:
QUANTITY: ~
MAKE: n
MODEL:
FUEL: (N~ ~aS
FLUE SIZE: r1
OUTPUT: ~ d~~
CFM TOTAL:
CFM OUTSIDE:
i TONS:
H. POWER;
APPLICANT' S SIGNATURE: ~ DATE:
HEATING EE RATES:
Residential: Commercial:
New Construction: $40.00 10 of contract cost, up to $10,000
($39.50 + .50 surcharge) and 1/2' over $10,000 + .50
.Minimum: $20.00 ($19.50 + .50 surcharge surcharge. Minimum of
$24.50 + .50 surcharge ($25.00)
HEATING, VENT, & AIR COND. PERMIT APPLICATION PAGE 2
OFFICE USE
FUEL TYPE: WORK TYPE:
~gl) NATURAL GAS ~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: $ ~
OTHER: $
TOTAL: $ ~C~ ~o~
APPROVED BY: DATE: