HomeMy WebLinkAboutMechanical 99-350
DATE TIME
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5689 /'A1CO/A//lC- 121046
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SC;HEDUU:D
ADDRESS
OWNER
CONTR.
PHONE NO,
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
DFI~
TE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
SEWER HOOKUP
o ~NAL
o MECH FINAL
COJl4.MENTS'
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PROCEED
N AN' PROCEED
L FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALl 447-9850' FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE ~MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
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CITY OF PRIOR LAKE MC _
16200 Eag(e Creek Av. S,E, Permit No. qq - 3t:;>U
Prior Lake, MN 55372
TYPE OF STRUCTURE
I. rink
2. (lr~n
), Ydlow
Pile
City
Conlractor
-
HEATING APPLICATION I PERMIT
Date L\ -q....~q PID # 2..5 - Z-. 'rq - 02..9 - 0
Site Address -5 ~ (l1"\r'(b00 \ ~\ch 0 \\/'k \ \
v' -
Lot q Block 2- Addition eAl2.DINt\L ~O~6 I b""I""' f';DDN.
owner'sName~~ u.ve.r-eJ) 4-
Address S r8"'1 (' c:tr-Lt \(\(i l 'il" do 0 "'\lX\ \
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Heating Contractor ~ \J \ \L- w..~ ~\ '~A \, f\ \ c.., .
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Address \d.L\~\ e...-~ ~ ~ ~)..IJafL-
Telephone# lo\Q-~~- ~'S'"
Single Family
Commercial
~
Two-Family
Industrial
Public
Multi-Family
Other
Fee Schedule
~
o
5
flY
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1"10 of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Remember to add the State Surcharge on the bollom of this application.
Input
Output
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical House Heating Test Record must be submitted with buildinq permit [lumbe( before build-
Air Conditioning ~r'{M+- ~J)"(D10 ing certificate of occupancy will be issued. .
Vent. System ;;;}.. "5" -tvI\
. HEAT CALCULATIONS BEQUIRED with number of supply and return openings listed per
HEATING OR POWER PLANT room with CFM's per opening. New structures or additions send floor plan with supply
Stoam _ and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
Hot Water APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
Radiation CREEK AVE. S.E. PRIO:1LAKE, MN 55372.
Special Devices
The price of your heating permit includes one rough-in and one final inspection.
Furnace Make & Model
Model Size
Additional inspections will be billed at $35.00 each.
Conn. Load
Fuel
Flue Size
Supply Openings
Return Openings
City Hall business hours 3re 8 a.m. - 4:30 p.m.
Edr.
Other Devices
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-4230
Cfm.
STATE SURCHARGE $
Est. Compo Date
Building Permit #
~q, "5D
.50
Y b .O(!) Receipt #
qcr - 35V
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case of all work whir.:h requires review and approval of plans.
TYPE OF WORK
Alterations
Replacement ')(
New Construction
Repair
Est. Cost $
T01AL PERMIT FEES $
3S01B
,
~933
Date
4-/I4-/qq
Date
HEAliNG PERMIT FEE $
Building Olfical'sSignattlfe