HomeMy WebLinkAboutMechanical 99-104
~; OF PRIOR LAKE
~ I SPECTION NOTICE
~ ADDRESS LlLlI'l.
OWNER
PHONE NO.
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
COMMENTS:
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DATE
TIME
SCHEDULED
317-qcf
"3:7'0
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CONTR. /-- . '\
PERMIT(' qq - ) () t\l /
o PLUMBING RI - . -~D/FILLlNG
o MECHANICAL ---0 LKSHORElWETLAND
o WATER HOOKUP 0 COMPLAINT
o SEWER HOOKUP []~EPTIC FINAL
o SEPTIC INSTALL ~FIREPLACE
o PLUMBING FINAL 0
o SITE INSPECTION
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Inspectcfr: I Owner/Contr:
CALL 447~230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
COYUIREMEN18 ARE FOR YOUR PERSONAL HEALTH & SAFETY'
HEATING APPLICATION I PERMIT
2-17-9'7 PID# c}5- 3;n-(jJ7-0
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CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No.
Prior Lake, MN 55372
Date
/'r;o.r VVtitf(.1 ~I/ed
Addition /.).fl (' f,17 f"~it' Cr~~t<
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Heating Contractor 7"0.0 ;;,/ve I/~ k .
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Address. /r~70 tk~~./.a he. #127
Site Address
Lot
Block
Owner's Name
Address
Telephone # ~cn>-:Y~6>
Furnace Make & Model -1)~ dhce
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1. Pink
2. Green
3. Yellow
File
City
Contractor
TYPE OF STRUCTURE
/" Two-Family Multi-Family
Single Family
Commercial
Industrial
Public
Other
Fee Schedule
1/1" liaS
1% of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
Remember to add the State Surcharge on the bottom of this application.
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 ~LCULATIONS REQUIREQ 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.
Model Size
i'jL ))0
Conn. Load
Fuel
Flue Size
Supply Openings
Return Openings
Input
Edr.
Cfm.
Output
Other Devices
TYPE OF WORK
Alterations
Replacement
New Construction
Repair Est. Comp. Date
Est. Cost $ Building Permit #
HEATING PERMIT FEE $ ~q - ~O
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
M>.-
,
Receipt #
;4l (0
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
case of all work which requires review and approval of plans.
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'Building Ottical's 'Signature