HomeMy WebLinkAboutMechanical 00-800
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 5535 ~j4 T ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FRAMING 0 MECHANICAL
o INSULATION 0 WATER HOOKUP
o FINAL 0 SEWER HOOKUP
o FOUNDATION 0 SEPTIC INSTALL
o DEMOLITION 0 PLUMBING FINAL
o FIRE PREVo 0 SITE INSPECTION
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DATE TIME
9//9 jM
16:~
(j-800
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o EXC/GRAD/FILLlNG
o LKSHORE~ETLAND
o COMPLAINT
o SEPTIC FINAL
~ FIREPLACE
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o WORK SATISFACTORY, PROCEED
A CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~, Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No. 00 - oe;OO
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
Date ;:::; ep-i- .. s-+^ J1() PID # J.e:. -o4-() - tJZ- 7 - 0
Site Address SS- ,SS ,"5'h rrv (J. '1' Y'r..l i I Jtl 6 /f?/so
Addition Industrial, Commercial & Multi-Family 1 % of job cost ($39.50 minimum)
tI . \ ("' ~ \ \ J Residential, Heating & AC $99.50
Owner's Name _" Q.. \) \ \'\. .,:) ~CA \1\ e ~ . Residential, Heating Only $64.50
,c:.; e:;-~ S ~..QJ' p., -crl)ll. \ J1l....f:. Residential, Gas Fireplace $39.50
t'--o , .1\ (! / It. l ( J If'." .... ~ Residential, Additions & Alterations $39.50
Heating Contractor \- '\ ~ ~-S { ri e l.? f' rye-V] J, f C o"eS;}1J1 e Residential, AC Only $39.50
b?SO IV, t+ (_~ !"< (JUt'Y15C///I~#1)1j,
Remember to add the State Surcharge on the bottom of this application.
Lot
Block
Address
Address
Telephone #
Furnace Make & Model J::. tteett -W.....Gbs AIR CONDITIONER UNITS CANNOT
. ~::: tArr- <::". .-r: ,r- ".~ ENCROACH INTO SIDEYARD SETBACKS.
Model Size ....::tJ l-~I.t()('Q.LM..e.. ~T'
-~ TYPE OF SYSTEM
Conn. Load
Fuel ~) r;; J
Supply Openings
Return Openings
Input gooo 0
Edr.
Cfm.~(/l r)
Flue Size
Warm Air Plants
,., I( r:t Gravity
C)'o..- 3 ,- j By Mechanical
/""fkBVAir Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Other Devices
Output.
TYPE OF WORK
Alterations Replacement New Construction
Repair , Est. Camp. Date _ \ /I 0 f r / r;;.j-f h ,
Est. Cost $ .l/..o..f1o Building permit:: ~ '- D!'J.O 0
HEATING PERMIT FEE $ :::J.I1"S'V
STATE SURCHARGE $ .50
TOTALPERMITFEES $ 4-0.() () Receipt # 36~ 0
I
Single Family
Commercial
TYPE OF STRUCTURE.
V Two-Family
1. Pink
2. Green
3. Yellow
File
City
Contractor
Multi-Family
Industrial
Public
Other
Fee Schedule
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 Dermit number before build-
ing certificate of occupancy will be issued.
HEAT .Q.ALCLJLATIONS 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
Phone: (952) 447-9850
Fax: (952) 447-4245
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,",;r. Wh;~h requ;re"Rr;A~ approval of p;~ 7: ~ kY
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~LX- 9.5'00
Building OffiCi Signature Date