HomeMy WebLinkAboutMechanical 99-0023
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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ADDRESS 5783
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CONTR.
OWNER
PHONE NO.
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREV.
CO~ENTS:
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PERMIT NO.
9'1- 23
n..- ~LUMBING RI ~, J .
~ECHANICAL rNl.o'
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLING
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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Inspector:
Owner/Contr:
CALL 4i 7-4230h=OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE R~MENTSARE FOR Y~UR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No. 91';;0;2.. ?
Prior-lake, R'iN 55372
1. Pink
2. Green
3. Yellow
File
City
Contractor
TYPE OF STRUCTURE
HEATING APPLICATION I PERMIT
Date I - '7 -qq PID# 25"-082> -()2.0 - 0
Site Address') 183 k I hn ''1 "f C IYL Ie PoCo'-- Lttl ml'l 5.iJ7 ~Fee Schedule
Lot 20 Block. I Addition D f} K R,~~ ~ LOl.N+-- .I ~ MD, Industrial, Commercial & Multi-Family
D ;/ I .Jj Residential, Heating & AC
Owner's Name . 1..1 a. f} e lfLl fI.. p. R 'd t' I H t' 0 I
. eSI en la , ea Ing n y
/; r; 8' 6 r:. fA. I b, \ II h"; C1 I"r Je Residential, Gas Fireplace
If'\ R I cI 5 Residential, Additions & Alterations
IL ;UC)(I'-<L. f'-(Ylc R 'd t'l ACO I
eSI en la , n y
Single Family
y
Two-Family
Commercial
Industrial
Public
Multi-Family
Other
Heating Contractor
1% of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Address
Address
:5 r.l/(Y1 f d!) C1..- ba IIIl
Telephone # .~ WO-Q7d7
Fh..t1-D f: low) 50 q I.
furnace Ma~ 1 Model . (0' ~ DJ t '-/ Z- TYPE OF SYSTEM
Lndf"'~~,,+ .110- yn....' Warm Air Plants
Model Size ~l '0.., vI(R?'n()A3~ Gravity
Mechanical
Air Conditioning
Vent. System ,
Remember to add the State Surcharge on the bottom of this application.
Return Openings
Input Output
Edr.
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 numb~ 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.
Conn. Load
Fuel~
Flue Size
Supply Openings
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
Cfm.
Repair
Est. Cost $
Est. Comp. Date
Building Permit #
~
-
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 WhiChnires .reView and approval of plans.
D D h&:.v. 1:::;. ~u1-'r&h (- 7-99
. "~Iicant's Sigmiture _ Date
(/ /t-- / 7-/"9
,...~ Building Offical's Signature Date
-f"v..'" ""c- L
Alterations J}.D (). f-, Df".Replacement
TYPE OF WORK
New Construction
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
3 9. ':)0
.50
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Receipt# '3431 ~