HomeMy WebLinkAboutHeating Permit 01-0714
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TillE
..5..-;'0;/
ADDRESS
~5ro ~/9/CK-WO.()O
OWNER
CONTR.
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
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
61,0114-
o EXlGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Cantr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
1. Pink
2. Green
3. Yellow
File
City
Contractor
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No. 01- 0 7/4-
Prior Lake, MN 55372
TYPE OF STRUCTURE
Single Family X.
,
Two-Family
Industrial
Multi-Family
Other
HEATING APPLICATION I PERMIT
7;;-(/1 Plo#.6-3/1- 02-7-0
Commercial
Public
Date
---., ,
'Add L. 1/ <:'-, . ~. d/ -' ..~ '''' ,~ r'
Site ress '/6::;7,_-'1--7, '///ff I..~//_.t/[J ;/i/. ',1'::.
Lot. (0 Block 4- Addition f/VOOOI<.JO;;'e- ~1'~76S 3.eo
r' /-' ""'.'"
Owner's Name ra / /;.., ('7//(:./ f
Address 9/./5;:/ /t;;/t,/r.c.c:d j);/ 5.;;
Heating Contractor 11.-1 )1// ~ k/ /2"'1 IYJ 1i'J/Jt' iJll"-; /)
. -. VJ v
Address I;:), '-/0 fA .//f; t A 11/// ?h.//A j #J4J/~" /);/J C7)Ji{j iI
- .. /1 ' /
Telephone # tj/;) '-.;1,;;)/. ExJ90
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
PLEASE NOTE:
Air Conditioner Units Cannot
Encroach Into Required
Side Yard Set-Backs
Remember to add the State Surcharge on the bottom of this application.
AIR CONDITIONER UNITS CANNOT
ENCROACH INTO SIDEYARD SETBACKS,
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Other Devices
TYPE OF WORK ..I/}~/IU:I Jt2~d,!y tv/~#{~jt?/P/
Furnace Make & Model
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections will be billed at $35.00 each.
House Heating Test Record must be submitted with building oermit number before build-
ing certificate of occupancy will be issued.
Model Size
Conn. Load
Fuel Flue Size
HEAT CALCULATIONS REOUIREQ with number of supply and return openings listed per
room with CFM's per opening. New structures or additio\lS::s~ fJoor plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, F"AY~ENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE,16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
Supply Openings
Return Openings
a t 7 2001
Input Output
Edr.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Cfm.
Phone: (952) 447-9850
Fax: (952) 447-4245
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
4~$&~ A -
-./ /PPliC~J;S~v_
Buildincroffic3ai's Signature
.-
5(
Alterations
. Replacement
New Construction
Repair
. Est. Compo Date
()1-07/~
~ ---., r:
Est. Cost $ rJ., -( ), DO
Building Permit #
/'/09/4/
Date
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
:..../ () I ~ Receipt #
/./~.ol
Date
40/20