HomeMy WebLinkAboutMechanical 99-0955
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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ADDRESS
5q~t./- (!K.o~<!,qN..oe)T
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Qt:;-Cf55
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP ~IREPLACE FINAL
o FINAL 0 PLUMBING FINAL Y"O-' GASLINE AIR TST
o SITE INSPECTION 0 MECH FINAL )Bl t::", p. ~c.,. ~~.
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IWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W!t~' CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ I Owner/Contr:
\
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE MC
16200 Eagle CreekAv. S.E. Permit No. ~-q5~
Prior Lake, MN 55372
Date
Address
Telephone #
Furnace Make & Model 5L-7:>1J TJZ..s
.((
Model Size -3 to
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Conn. Load
Fuel AJ (j,
Flue Size
_ l
c? 1(1 J/j J/
Supply Openings
Return Openings
Input . ~ 61OOC' Output.
Edr.
Cfm.
Other Devices
TYPE OF WORK
Alterations
. Replacement
. New Construction
Repair . Est. Comp. Date
Est. Cost $ / ;Loa f cro Building Permit #
HEATING PERMIT FEE $ ~ .sv
STATE SURCHARGE $ .50
TOTAL PERMIT FEES $ 40.00 Receipt #
99 - 955
35G32..
1. Pink
2. Green
3. Yellow
File
City
Contractor
TYPE OF STRUCTURE
Single Family
Commercial
v
Two-Family
Industrial
Public.
Other
Multi-Family
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1 % of job cost ($39.50 minimum)
$99.50
$64.50
C. $39.50
$39.50
$39.50
Remember to add the State Surcharge on the bottom of this application.
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections will be billed at $35.00 each.
House Heating Test Record must be submitted with buildinQ permit number before build-
ing certificate of occupancy will be issued.
HEAT CALCULATIONS REQUIRED with number of supply and return openings listed per
room with CFM's per opening. New structures or additions send floor plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-9850
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
l-e:ziZi;;;;ew and approval of P'd ~7 7
v: Jl>PI~r.s ~igtlature . ;'. ' "Date
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