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HomeMy WebLinkAboutNo 10691 3u~.y_ 12, ,19 City of Lakeville .:.HEATING PERMIT Permit Fee 2'3.50 Revel pt State Surcharge .50 TOTAL FEE PAID ~ Permission is hereby granted to Gol~trt~ 1~.~c~ A:i.r f A~:i.'~1er C~+lst, Building on Lot No. ~ Block L Subdivision~.3;"~' Val 1 ~v Parma F~~-h ~r_-~~in Parcel ?'Z?°''177-f19~)-fd~l: Plat In theClTY OF LAKEVILLE to be used as P~'rtnir in~ta"t1 }te~tin.~ i„ r~ ~ cun~~-rt~rtat~n This permit is issued on the express condition that the ERECTION _~LTERATION -REPAIRS -ENLARGEME~AIT -JIIIOVING DEMOLITION 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 .~-h~~' ~ r"~z2~n ~o G1e~~tn. e1. ~,an~;~trc1 Director, License and Inspection Attention is particularly called to the cutting up of streets, making main sewer `-I connections, driveways and curbs. ObtainpermitforsuchconstructionfromtheClTY ~ ~ a' ~ OF LAKEVILLE. Inspection Department Not Responsible For Any Damages to Public By ~ Utilities. ^ CITY OF LAKEVILLE Date : ~ ` ~ l ' 7~ ~stz~ ass-44at CITY OF LAKEVILLE 8747 -208TH ST. W. • BOX M LAKEVILLE, MN 65044 INSPECTION DEPARTMENT - APPLICATION FOR HEATING PERMIT Site Address: ~ ~ ~ ~ ~ ~°e.C ~ p,~ Alter Repair Install Repair Legal: Lot .j Block i _ Addition MAKE ~ E TYPE OF SYSTEM SIZE ~ ~ Worm Air Plonts CONN. LOAD Gravity FUEL Q~~ ~ S f,~-" i t Mechanical FLUE DIA. Air Conditioning SUPPLY OPENINGS Vent System RETURN OPENINGS Heoting or Power Plont INPUT_ ~ I C~ Steam OUTPUT Hot Water EDR Radiation CFM Special Devices Other Devices Plan No. ~ ~ ~ ~ ~ Date t ~ Est. Comp. Date Est. Cost Heating Permit Fee Gas Piping Permit Fee Total Permit Fees ~C) ,C~ Owner's Name Address ~ ~ E? ~ Q INeating Controctor~ Q ~ r~~ ~ ~ C- Telephone : - ~p Address \ • ~x ~ ~ City T-O.~ (~O pd~J Zip S~ d Heating, Air. Conditioning, Ventilation & Refrigeration Permit Fee for single family residence in- stallation j Alteration or Repair Min. Fee_______________________~___________________$ Non Residential Fee shall be computed of 1 % of the contract _ _ _ i Gas Piping Fee for each installation______________________________________$ ~ Send application and heat loss calculation with check for Permits to: CItY OF LAKEVILLE Inspection Department Box M Lakeville, MN 55044