HomeMy WebLinkAboutMechanical 99-841
FRo. -'.~~ --:-1- 9
a~ d, ./
oJ',~~
Pink
an-
YcD.<M
\.
1-
3.
E
Ll
CITY OF PRIOR LAKE
18200 Eagle Creek Av. S.E. P"m~ No.
Prior L8k~ tAN 55372
'-l
C
r
--.J
......
l.D
l.D
l.D
N
N
l.D
-0
3:
3:
I""l
-I
AJ
o
D
H
AJ
MultI-Family
Other
1% 0' job cost ($$9.50 minimum)
$99.60
$64.50
$39.50
$39.50
$39.50
Public
Tw~FamMy
Industrial
~~-,
Industrial. Commercial & Multi.Famlly
Residential, H-eatlng & AC .
Residential, Heating Only
Residential. Gas Fireplace
Reslden"al, Additions. Alterations
R68idential, AC Only
~1"
Fee Schedule
Single Family
Commercial'
qt::l-!34/
.1Jp
J PERMIT
Date
Site Add...
lot 2.. BlQck
OWnsf. Name
Address
this appllcaliGn.
The price 01 you.r heating permit includes one rough-in and one final inspection.
Addllionallnspecllons will be Dilled at $35.00 each.
House Heating Teat Record mus' be submitted with bYiliIlDg ~ ~ before build-
ing certlficate of occupancy will be Issued.
J:1EA1 CALCULATIONS REQUIRED with number of supply and return openings listed per
room with CFM's per opening. New structures 01 additions send ft001 plan with supply
and return locations shown, HEAT LOSS CAlCUIJITIONS, PAYMENT AND
APPUCATlONS MAY BE MAILED TO THE CITY OF PRiOR LAKE, 162.00 EAGLE
CREEK AVE. S.E.. PRIOR LAKE, MN 55372.
City Hall bUSiness hours are 8 a.m. . 4:30 p.m.
AU. WORK MUST BE INSPECTED (ROUGH.IN AND FINAL). CALL CITY HALL
441-4230
Remember to add &he State Surcharge on the bottom of
TYPE OF SYSTEM
Warm Air Plants _
Gravity
Mechanical _
Air Conditioning _
Vent. System _
HEATlNG OR POWER PLANT
Stnm
Hot Water _
Radiation _
Special Devices
IU8 Size ~(.
f]
~
'S ()60
Output
SupplV Openings
Return Openings
Conn.
Input
Edr.
Fuel
I hereby apply for a mechanical systems permlt and I acknowledge that the
information above Is complete ~nd accurate; tnat the work will be in con'ormance
wl1tl the ordinances and codes of the city and witn the stale building/mechanical is
codes; that lhis 'orm does not become a permit until signed by the BUtLDING Co
OFFICIAL; that the wOlk will be [n accordance with the approved plan in the ~
case of all work which requires review and approval of plans.
Devlces
New Construction _..tI
Other
TYPE OF WORK
RepJaoement
Est. Comp. Date
BuUdlng Perma,.
Cfm.
Alterations
-0
N
o
otct~
~
6&~
tf9...5Sb
.35~3 2-
Receipt 'II
.50
bO
Repair
Est Cost $
HEATING PERMrT FEE S
$
$
STATE SURCHARGE
TOTAL PERMIT FEES
ADDRESS
/702/
DATE TIME
SCHEDULED ej fZ,/t:fl 2:00
FIs;ff pr;eo
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
qq-~
-
PHONE NO.
PERMIT NO.
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
~ PLUMBING FINAL
r~ MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~MENTS:
\ht~~~~
Y c--e 2\J .( u v c:::..:
~~ r}..
j,
. \/ G/V'
*At
Srv~
0."'\='0 ("L
Le~ \ "^ '"J
OR REINSPECTION BEFORE COVERING
Owner/Contr:
o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
UIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
.__.-,.,-_.~-,------------' - --..,.--. ..."..__..~.__.~-_._-------_._._--~~_.._-'-_._--~-'--"
TOTAL PERMiT FEES
l
STATE SURCHARGE
$
$
.50
bO
Rec&ipt 11
3..5~3 2-
HEAliNG PERMrr FEE $
Repair
Est. Cost $
Alterations
?
,
Replacement
Est. Comp~ Dale
Building Perm~ II
cf9--5!!3b
New Construction
'?
.
I hereby apply for a mechanical systems permit and I acknowledge that the
information above IS completa ~nd accurate; thaI the work will be in conformance
wl1h the ordinances and codes of the city and with the siale buHdinglmecltanical
codes; thaI \his form does nol become a permit until signed by the BUILDING
OFFICIAL; that lhe work will be in accordance with Ihe approved plan in the
case of all work which reQuires review and approval of plans.
TYPE OF SYSTCM
Warm Air Planls
Gravity _
Mechanical _
Air Conditioning
Vent. System
Cfm.
Supply Openings
Return Openings
Input
Edr.
Output
lUll Size ~~
T:]
~
..r
TYPE OF WORK
O&Q
Other
HEA llNG OR POWER PLANT
Stctam
Hot Water _
Radiation _
Special DevicQs
Devices
l:iEAt ~ m REQU IRED 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
APPUCATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 162.00 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours a.re B 8.m. . 4:30 p.m.
All. WORl< MUST BE INSPECTED (ROUGH-IN AND FINAL) -CALL CITY HALL
447-4230
Fuel
House Healing Test Record must be submitled with buildinC} ~ n!.l!!l!!M
ing certificate of occupancy will be issued.
Conn.
Modsl Size
Furnace Make & Model
N\
The price 01 your heating permit includes one rough-in and one final
Addilionallnspections will be biUed at $35.00 each.
before build-
inspection.
Address
Address
Sit9 Addless
loe 2- 61Qck ~ Addition
Owne"~ Nam 8
Healing
Remember to add Ihe State Surcharge on the bottom of
Fee Schedule ~i ~;.
Industrial, Commercial &. Mulli.F.amily
Residentlaf, rieating &. AC .
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alierations
Resfdential, AC Only
1 % 01 job cost
$99.50
$64.50
$39.50
$39.50
$39.50
this appllcatiGn.
($$9.50 minimum)
HEAnNG APPUCATlON J
U
O'll
R
.1!Jp
Date
Single Family
Commercial'
PERMIT
CITY QF PRIOR LAKE
16200 Eagle Creek Av, S.E. Permh No.
Prior Lak~ MN 55372
CJq-f3t1/
l.{
"
Two-Family
Industrial
Public
Multi-Family
Other
TYPE
RUCTURE
\.
1.
J.
J'uII( 1'1~ - V
Oroee. lJty -..
yen- . ""'Coolnclrir,l.-.
~
"Permit" tt:
'JobAddress n6 ~( F,s{ rt-~ ~
"Heating Contractor M~T~~ t~
"Testers/Signature \J~
,.
Q~
II!!'!
Pounds
!'..!!'J1t1~!
"Gas Une
Pressurized
Inspected
Final Inspection
gERFORMANCE TEST
.::1 ~, 0 '70
('1 'Percent CO
. 1- '} ~ Q }I""
'Stack Temp. 0/. ·
Date f-I(j-~
"Percent C02
"Percent O2