HomeMy WebLinkAboutMechanical Permit #00-0132
HEATING APPLICATION I PERMIT
Date-", ~-13-ffi PID# Z5-/Z4- - oty:1-0
S'. Address 140;). 'S ~ l1~er.s AIlJJ YlI ,0 If'- I Fee Schedule
Lot C; Block / Addition go "OIAl5 M/lN(J~ Industrial, Commercial & Multi-Family
Ow r' N (1, I - 11 ) f' () ., {) /"\ Residential, Heating & AC
ne same Y't-'Il\l (~It-Tl. -n I .. .
- I -. ~ Residential, Heating Only
Address l..::!-.a..~ ~ ~ i-np AS AJ-P. _ Residential, Gas Fireplace
. Ii I r.. ^ ~ tt . 1 4-.... f! J; I Residential, Additions & Alterations
Heating Contractor ~ f')..Y1JJ c3 Il'> i fr1. ..J:::/r h R 'd t' I AC 0 I
. .,- \ \ ' . . eSI en la , n y
Address l2l:0~ tionPRr ~ F-<JLeh ~'I/2J""e/Jrfl.Jc<;S3<17
Telephone # -.S6 d -.. OJ 4 I _ l...J ~1 J.1 Remember to add the State Surcharge on the bottom of this application.
(Furnace ~e & Model }\-VV'\f.\.V\rA/TUJ(!J)1D TYPE OF SYSTEM
. Warm Air Plants
Model Size JD. (')("fD Gravity
Mechanical
Air Conditioning
Vent. System
Repair Est. Comp. Date
Est. Cost $ $1 qSD . (jf) Building Permit #
HEATINGPERMITFEE~ .39SO
STATE SURCHARGE $ .50
TOTAL PERMIT FEES $~ Receipt #
~ $4~.O()
Conn. Load
Fuel
NIrT
Supply Openings
Return Openings
Input
Edr.
Cfm.
Alterations
CITY OF PRIOR LAKE
16200 Eagle 'Creek Av. S.E. Permit No. (?fJ -0/32-
Prior Lake, MN 55372
1. Pink
2. Green
3. Yellow
File
City
Contractor
TYPE OF STRUCTURE
x
Single Family
Two-Family
Multi-Family
Commercial
Other.
Industrial
Public.
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50 .. t 5 2(D)
$39.50
$39.50
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 permit number before build-
ing certificate of occupancy will be issued.
Flue Size
HEAT CALCULATIONS 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.
Output _
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
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
Other Devices
TYPE OF WORK
Replacement 'X
~- \
New Construction
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
X (\or\[ lu=iew and approval of Pla:~._ B-~
-:;::J.pplidmfs Signature , Date
/ ~/JIJQO
Building Offical's Signature ~te
~~ -,""Z,(")-~
- -
O{)- () 132-
3t~qf10
CITY OF PRIOR LAKE
1,t<lSPEC1ION NOTICE
. SCHEDULED
-, . ...
.l}-~ ~ ~~ Do
ADDRESS
l40L c::::; ~... 06?-5
OWNER
CONTR.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
PERMIT NO. ..
o PLUMBING RI ~
o MECH RI -
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
O~)~ /~I ~
FL-vG- V-
It;> v4t-v-,S-V
~4--' LcNG-- V
Co~_~
~ )\
/' cUJS6 Ac.65 )
( '/
\ ~.
'-..::!.. --------
~e>-)1:-i--,
-'" .---'
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o r::' lJ RtV Ac.C
~
WA--Tt:'L ~ .tfJ
PHONE NO.
COMMENTS:
/
hRK SATISFACTORY, PROCEED
o CORRECT ACTION AND ROCEED
L FOR REINSPECTION BEFORE COVERING
Inspector: t Owner/Contr:
, '- I ~
CALL 447-9850 F'OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTl
IS. House HEATING TEST
'-1c>2 (L~,~ (r APT.
. OWNER
ADORns
OCCUPANl
II'!AT lOSS
SOlO t'Y
el.ettlce' w.... B, .
TYPE OF HE"T
DA TE HTG. IHIT.
'\--1 b-u 0
OA ~A~H.
A GAS DESIGN
H7~~
kl.4{C 0"70 C t&-~C1
4'cr o~'Z.-o, 6o~
-/~ 6"01:)
MAKE
Mo4.,
Ser,.I
INPUT
~ COHTROLS
THERMOSTAT v Q / .~.~! PIII9'
V.I;. JI:!Y'- 36 ~
L'"," ~~ L.-t'lo-vlJP-
lI...;, ~"'"'r ~-
F." Se"'n, . fh".!
Pilo' T," /l/dr'l/'
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Pil.. Mo".I_
P tI., T'",'",
L. w. C", Off
P,;..",., J~~h
'''u' CFH .,~
Stee," T.",... ~
P.,co", CO) Y'"?",
,POtU"' 02~
PorCO"' CO ..J2.d52I
. IT!AM
INSTALLED IY .
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~PAC! HT..
MAK! 01' IU...!It
Me.I
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MA K! OF FURNACE
Me".I
v.". S'"
KIND OF L1NU
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RECORD
FLOC" .
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SUIURI
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UNIT HTlI. OTHER
CONVERS'ON
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