HomeMy WebLinkAboutMechanical Permit #00-0133
CITY OF PRIOR LAKE MC
.16200 Eagle Creek Av. S.E. Permit No.
Prior Lake, MN 55372 ;>
no-o/33
Date
Site Address
Lot Block Addition
Owner's Name ~/'( rn oY\ ( ~, U ~ ( ( y
Address 1 S S <1'3 h ~ .p~ (Y\ { ~&
\ "" - '-
1D.l'l f.ldmIMIIIIla
Heating Contractor ;;;--- '~.I~~~LAI(ESmr.Ef
tl"j,,",~ ~
",- --;;:;O,"J'lftMN
Address . ~1~ :-:-f.?!,.;:"
Telephone #
Furnace Make & Model ~C
Model Size 10-0 . ()ffV
P3#C1.,(f TYPE OF SYSTEM
4../ Warm Air Plants 'X.
.~~ 0 Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Conn. Loap~ I
4ftA JC'" I
Fuell\ ,.. C2tS Flue Size
...>
Supply Openings
Return Openings
Input {08 J ~utPut
Edr.
Other Devices
Cfm.
TYPE OF WORK
Replacement )( New Corstruction
Est. Comp. Date , ~ ()( tD
Est. Cost $ .1 ~ cr 0 - d:::> Building Permit # 00- 0 /33
HEATING PERMIT FEE $ 10 t{. $0
Alterations
Repair
STATE SURCHARGE $ ~ .50
TOTAL PERMIT FEES $ ~ Receipt# 3roo/B/
~ 40.00
TYPE OF STRUCTURE
1. Pink
2. Green
3. Yellow
File
City
Contractor
Single Family
Commercial
x
Multi-Family
Public Other
Two-Family.
Industrial
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 ... loam
c.. $39.5~.)
$39.50
Remember to add the State Surcharge on the bottom of this application.
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 puildinq oermit .number before build-
ing certificate of occupancy will be issued.
!-lEAT 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.
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 w' I be in accordance with the approved plan in the
CU"' ork which, ire reVi=pproval of PlanS":) (I I ef)
-~ - 3 /t~/~
Date
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
LSS43
SCHEDULED J. - ~
Fr~l1l?,r;11- eJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~/13
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
F (I' .....v11l t<...
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
Clo~
r~
,,'-1 _
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~3-0) Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
lNSNOTl
GAS W~K ORDE~
',..STANCAFlC -
. --~HEATINGO'"
& AIR CONDITIONING
/ A Blue Dot: Service CO. EQUIPMENT INFORMATION
LAST /~ 'tAA I!~ ' FIRST (!.fIV/1dl'll TYPE
ADDRESS /,-)2f3 ~J t. ?o/lV I- /-z.c.9. MAKE V6r-lL
CITY P Tl ZIP "37 '2- MODEIf '3 H Ll1't1 (,.. A JoB t.xJ111
HM PH c, (l- - ~'I()- 9"SJvWK PH SERIAL.tM?M, L{54 qq4
TECH ?/~ DATE ?--'3-2u-v-o I~ '1- ~- 2..uzr"b
ORSAT TEST RECORD .
% METERED INPUT h1J cfh CHIMNEY TYPE I, /t1t.//
% LIMIT SETTING 1 t./ f) 0 FLUE SIZE if in.
% PILOT OUTAGE .1) sac CONNECTOR SIZE ft in.
NET STACK TEMP ~ <;,1 ~________~._._~____._.___~~TA~ C~~MNEY INPUT /'1'2-) ~Oi).__~~~~___ _"
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f()72.P~~~. ,; .
St. Paul, W,; 55101 \ MA'\
651/772t214W1\ 2. {JPJ
C02 0
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'O?J~O/33
410 W. Lake St.
Minneapolis, MN 55408
612/824-2656