HomeMy WebLinkAboutMechanical 99-249
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
S8SCC ~,...". _ trcL~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
COMMENTS:
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DATE TIME
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3':00
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o LKSHOREnNETLAND
o COMPLAINT
,^ 0 SEPTIC FINAL
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Inspector: / I Owner/Contr:
CALL ~7-4230 FOJHE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE ~TS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
.
CITY OF PRIOR LAKE MC /?1 Ilq
16200 Eagle Creek Av. S.E. Permit No. ...... rf - Z '1
Prior Lake, MN 55372
Address
Heating Contractor
Address
Telephone # _
Furnace Make & Model TYPE OF SYSTEM
~ ~dA' ~arm Air Plants
Model Size ,'J1.. 1~ ( ~C Gravity
m . i:E M/),p,if~ .
Conn. Load Mechanical
Air Conditioning
Fuel Flue Size Vent. System
Supply Openings
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Return Openings
Input. Output
Edr.
Other Devices
Cfm.
TYPE OF WORK
Alterations
'/<... . Replacement
New Construction
Repair
. Est. Comp. Date
qq -'240
Est. Cost $ Building Permit #
HEATING PERMIT FEE $3Cj ~50
STATE SURCHARGE $ .50
TOTAL PERMIT FEES $ 46 - ciJ
~ L(~ Ltc)
Receipt # .
1. Pink
2. Green
3. Yellow
File
City
Contractor
TYPE OF STRUCTURE
Single Family
Commercial
:A-..
Two-Family
Multi-Family
Other.
Industrial
Public.
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
$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 oermit, 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
ca2;;;)!) ZJ.es review a~pproval of Pia; _~/ -r y
- ;- " r./JPP1i~?m-Jigna ...Cl~ ' :' Date - c
K~tIrK ,.t,y.-" i':e- 3/JI If 7
l I!'"uifaing Offical's Signature ' Date (