HomeMy WebLinkAboutMechanical 00-0997
CITY OF PlttpR LAKE
IN$FJECTION NOTICE
DATE TIME
SCHEDULED
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AD )RESS
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C~'J
O\ll'NER
PH )NE NO.
PERMIT NO.
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o FOOliNG
o F M.MING
o INSULA liON
"rJiFINAL
1] F :::lUNDA liON
o [EMOLlTIQN
o f 'RE PREV,
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTAL.L
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLING
o LKSHORE^NETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
Gol ~MENTS:
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~ )RKSATISFACTORY, PROCEED
o CI IRRECT ACTION AND PROCEED
o CI IRRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Insp .ctor: ~ . Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
I GD~C~\
ADDRESS /{3 '17
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OCcUPANT
HEAT LOSS
SOLD BY
Electrical Work By
TYPE OF HEAT
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/J AiOUSE HEATING TEST RECORD
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DATE HTG. INST.
CITY
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SUBURB
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MAKE OF BURNER
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Mox. BTU Rating
MAKE OF FURNA"'''
Mod.1
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Pilot Type
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KIND OF LINER
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CITY OF PRIOR LAKE);'
16200 Eagle Creek Av. S.E. Perm~ No. 00 "~lJ9.q1
Prior Lake, MN 55372 ill'!
. HEATING APPLICATION I PERMIT '" ".
Date \\~C\ -CD PID, . Z 5 - D ZI~ - O'!i# - 0
S~e Address' \~~L\l ~Q::i( \4;. -Yrnr\
Lot _ Block Add~ion
Owne(s Name \:' f',-" \=-" >v-oo. ''2. (,>f'-, .
Address Cleo.. 'i"C'D' (\s C\.\-D \) Q-
. VOGl HEATING & AIR CONOmONING
Healing Contractor ~l6e GOAl lAM A',::.
Address
ST LOUIS PARK, MN 55426
SALES 929-6767 SeRVICe \l29-4U11
::y: ...;",.; ......e-#----
Furnace Make & ModeW~I'('
(..,. 7 Jcf02. -5CJYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Cond~ioning
Vent. System
HEAliNG OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Model Size
n()
Conn. Load
Fuel~\\\ \'/0 h'bFlue Size
Supply Openings
Return Openings
Input Pf) () 'Xl . Output
I
Edr.
Other Devices
Cfm.
A~erations
TYPE OF WORK
Replacement , / New Construction
Est. Comp. Date -.17- -In ~o()
-"1 \ f\(') ,('):) Building Perm~ #
qC\. sO
Repair
Est. Cost $
. , .
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
\ \)\1 .f~ Receipt #
,
_~I.o -;4-
TYPE OF STRUCTUR~
1. Pink
2, Green
3. Yellow
File
City
Contractor
Single Family
Commercial
,,/ Two-Family
Industrial
Public
Multi-Family
Other
Fee Schedule
Industrial.. Co"'lll8<Cial-!. Multi-Family
(Residential, Heating. & Ac-::.
Residential, Heatlr,g Only
Residential, Gas Fireplace
Residential, Addijions & 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 Surcharoe on the bottom of this aooUcalion,
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 buildino ~ numhA' before build-
ing certificate of occupancy will be issued.
!:!fAI ~ALCLJLATI~ REQUIRED with number of supply and return openings listed per
room with CFM's per opening. New structures or addijions send floor plan wijh 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
447-4230
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
c~e of all work which r:;uires review and approval of plans,
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