HomeMy WebLinkAboutMechanical 00-0353
- I
I
CIIrv OF PRIOR LAKE
IN SPECTION NOTICE
----
SCHEDULED
DATE TIME
_ 9:-ro
AnDRESS \4170 ~a.> k. 'l,,-
r
0' YNER
PIIONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
zS rS ,~
l_ iV--L +u
Illspector:
CALL
CODE
_..._--1--
CONTR.
PERMIT NO.
0.353
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
/J.. D...fIREPLACE FINAL
fJ~ASLlNE AIR TSf:p
O'\A.....-- 0,,", Gcv;.
~I"~J lC>.ct""J
Owner/Contr:
THE NEXT INSPECTION 24 HOURS IN ADVANCE..
TS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No. 00..0353
Prior Lake, MN 55372
Date
HEATING APPLICATION I PERMIT
-j/()'/ou PID# ZS-/38- 007- 0
/4-770 /'1;qpr~o 7-efi/C
/ Addition ()~/C (../'I-NO J3F.:J'h1J1 4-7]../.-
~~)J::j
Site Address
""t 7 Block
Owner's Name
Address
Heating Contractor 0"uLb"-'L hL[IUJcrz
Address /tl'n;vv'hA.J Ar/C jJiL,r;'L ~
~
Telephone # 1'-10 -A t1 ~
Furnace Make & Model Ulfr€'sf!L
. ~
Model Size i<j)VS1 R.
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Conn. Load
Fuel ;1J,A7(jyr<, Flue Size
Supply Openings
Return Openings
Input
Output
Edr.
Other Devices
Cfm.
TYPE OF WORK
Alterations
x
Replacement
New Construction
Repair
Est. Cost $
Est. Comp. Date
Building Permit #
{)(J- (j ?fo q
.
HEATING PERMITFEE$ 3Q.5O
STATE SURCHARGE $ .50
TOTAL PERMIT FEES $ 4-0. 0-0 Receipt #
37~3fy
TYPE OF STRUCTURE
I. Pink
2. Green
J. Yellow
File
City
Contractor
Single Family
Commercial
Two-Family.
Industrial
Multi-Family
Public
Olher
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Healing & 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
;"';,:.,-,-,.:;.,.".......... ,'" .......... ~he--Sta:.~ ::.......:1C..~'" ......., ~; ,>;i ;"'vuv", VI UII;:) Clt-JJ-III(";<111U! I.
The price of your heating permit includes one rough-in and one final inspection.
Addilional inspections will be billed at $35.00 each.
House Heating Test Record must be submitted with Qyj[gjng >&Ullil numher before build-
ing certificate of occupancy will be issued.
J:if& QALC1Jl ATIONS RFrll )IRED with number of supply and relurn 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 a 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 at the city and with the state buildingfmechanical
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 a,1I ;:0') which requires review and approval of plans.
jJ Ji,,-!1It~,f ~ ~ /J- / vi)
~ {~r\ure ~/D~(,.
5; 151 (/ 0
Date
BUiiffical's Signature