HomeMy WebLinkAboutMechanical 00-0884
~/
.~~:~ YRIO-?<~. . CITY OF PRIOR LAKE MC
& r;; 16200 EagleCreekAv.S.E. Permit No. 00.0604-
Prior Lake, MN 55372 r:
o ( H"ATING APPLICATION I PERMIT . f
Date q 111 00 PID # ~ z) q 3&1 D
S~e Address ., r.;"1 f ~ ~N\'4i'_ 'SJ:2..-/ ~ tJ e-
Lot Block .Add~ion JeAi ~, lI>>b II C} / r;. ;2-1
Owne(sName -r-Ctf>=d70re..-- - St''t:'--I AJ~o
Address 0 b t 1. % t:>.eA/\ '{""$Q./ s-r- I'Jt-
Heating Contractor
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Address .
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Telephone # &'r..J-- ~')...l(' ~ 2-C-,S(..
Furnace Make & MOdeIAfI.-.1~( 3S~ TYPE OF SYSTEM",
o bD ) eec:>1J "-r-r A Warm Air Plants ^-
Model Size Q - I Gravity
Mechanical
Air Cond~ioning
Vent. System.
Conn. Loa9 .
y1 Cut'C.d'f. (
Fuel _ ~. _ _Fiue Size
-J '-J
Supply Openings
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Return Ooeninas
Input
Output.
Edr.
Other Devices
Cfm.
TYPE OF WORK
Replacement X, NJw GJ"struction
Est. Comp. Date 1'0 ( (P( eo
Est. Cost $ 'J-.6't 0 Building Perm~ # 00 . oRM
HEATING PERMIT FEE $ ~,. $0
Ailerations
Repair
STATE SURCHARGE
TOTAL PERMIT FEES
$ .50
$ J.tO!OO
Receipt #
3 gLfd&
TYPE OF STRUCTURI;
I. Pink
2. Green
3. Yellow
File
City
Contractor
Single Family
Commercial
~
Multi-Family
Other
Two-Family
Industrial
Public
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Add~ions & Alterations
Residential, AC Only
1% of job cost ($39.50 minimum)
$99.50
-_.-~
($64:sb;,
$39.58,
$39.50\, .2. I 2000
$39.50. i
. L,
Remember to add the State Surcharge on the bottom of thlSllppliCatlOrr.
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 hllilrlinn IllWllil ~ before build-
ing certificate of occupancy will be issued.
HEAT CALCLJLATIO~ flFOLJIRFI1 with number of supply and return openings listed per
room with CFM's per opening. New structures or addilions send floor plan wilh 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
case 27JlQ;: ro~~:w~:proval of Plans'9 {{7 (rB
(J'~g::J (j:k6-0
l"irding Offical's Signature , Date
DATE TIME
CITY )F PRIOR LAKE
INS PI CTION NOTICE
SCHEDULED
/-1.-0'1-. 1(J~3.6
ADDFESS
h77J? LJ@l/fSG
OWNI,R
CONTR.
r183Lj
PHO~ E NO.
PERMIT NO.
/-'A'O
. .
o FO )TING
~FOJNDATION
11~ FRIMING
DIN! ULA TION
o FI~ AL
o SIl E INSPECTION
/I ~LUMBING RI
t'<t"" ~ ~ECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRAOIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
CON MENTS: (") f7U
u-~ ,
~lcAA\ ~~J rlUJ~uu-+ ~ ~)_
--
~C RK SATISFACTORY, PROCEED
o CO ~RECT ACTION AND PROCEED
o CO ~R~O'r\ CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ ,~l (J)JJ/ Owner/Contr:
C :ALL 447-9850 FOR T~E NEXT INSPECTION 24 HOURS IN ADVANCE.
,
( ODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
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1072 Payne Ave.
St. Paul, MN 55101
651/772-2449
LAST <-rPLj,,t+
ADDRESS t, 7 -1 J< UP f1 0 5<"
CITY p" v i' J. r. rt'n
HM PH 4sd. - 447- x: no
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TECH :.),.... <
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'" Gt~S WORK OROER
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$TANCARC
-'I-IEATINGO-
a AIR CONDITIONING
A Blue Doe Service Co. EQUIPMENT INFORMATION
FII'ST / j,p("),1,'f<2.. ITYPE
<; I .,./ r IMAKE (),( ,11"/\ T
ZIP <::- c- 17~ IMODEL '35""/)/l1/1UC3bo(-,O {J"ur(-I'
I SERIAL 3500 ;40 ,? 5' 3 ~
',I1NPUT (.-,C) GoO
410 W. LakeSt.
r.tIinneapolis, MN 55408
/ 612/824-2656
WKPH
DATE_G I~;l. /00
\- ORSAT TEST RECORD
, C02 (? I % METERED IN 'UT f.::,o' cfh CHIMNEY TYPE
02 q CJ _~:'" liMIT SETTI~ G J ('10 0 FLUE SIZE
'') &- % PILOTOUTAI;E ifl<+bAT sac CONNECTOR SIZE
,.AjTACK'1:EMp'18 0 ., TOTAL CHIMNEY INPUT 00.'
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