HomeMy WebLinkAboutMechanical 99-1226
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
1\ 0 FIREPLACE RI
I~ ..>f. FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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RE COVERING
'OUR PERSONAL HEALTH & SAFETY!
HEATING APPLICATION I PERMIT
Date -'lr-Jr-.. ~+f\ ; Cf.!l- PID # :z.s., 31" - o,~ - 0
Site Address .5Q:A6 C ('Cjss. 0. 'yl ~ '( C1.-5-1-. ·
Lot ~ Block. / Addition Met:? / A/)IJ-~ ~di€ 3~ Industrial, Commercial & Multi-Family
G , \ / Residential, Heating & AC
Owner's Name t' ~ f' (') { Jl.... P. R 'd t' I H t' 0 I
eSI en la , ea Ing n y
Address ~ a 5'" f v\ ("J <:; ~ ,<; t-... Residential, Gas Fireplace
r- \ \ & p'" - / ,. \ /J Residential, Additions & Alterations
Heating Contractor r \ f est e 'lI.r'J W~ {~ I ('~SJJJI.e Residential, AC Only
Address S)( ,-~(J (l1~-aJJ4Y-/~ fJv(t\Sf/(1/triJ1/v'~~P
& (tJ.. - 8" 90- 0 7- ~- t:? Remember to add the State Surcharge on the bottom of this application.
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No.
Prior Lake, MN 55372
1. Pink
2. Green
3. Yellow
File
City
Contractor
C/?-/zZb
TYPE OF STRUCTURE
IJ
Two-Family .
Multi-Family
Single Family
Commercial
Industrial
Public
Other
Fee Schedule
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Telephone #
Furnace Make & Model ~
Mgggl iiEe ~) -r..J2.
Supply Openings
Return Openings
Input _']CJOC'l(} Output
Conn. Load
Fuel
w:;.
Edr. 1;-: .....
Cfm. --Ir{;P..f:i
Alterations
Repair
Flue Size
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System .
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
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.
Other Devices
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
TYPE OF WORK
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 1J;: WhiCh, requir ~iew an~ova' of P'iti iff I?~
v Applica ~n.atu."'r.e .1... ( ~I DateL -,
~~ /t;../r--l-i.' ~ 7be:J
fh:...:.":' 'l /" -/
ic~"s :;iI.QIlalt:ir&'~~ ~te
Replacement
New Construction
Est. Comp. Date
Est. Cost $ 1JJ 0 0 .
Building Permit #
9'1- /Z,~(p
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.:39. 5:V
.50
40.o-d Receipt# 3~40B