HomeMy WebLinkAboutMechanical Permit #00-0167
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E, Permit No. (>0 - l (.'1
Prior Lake, MN 55372
_ HEATING APPLICATION I PERMIT
Date JJ.C( ~ On PID #.25 435" - 0/4---0
Site Address 't & t.f ~ ( () rd ~ .J:I ;t..}. e .
1. Pink
2, Green
3. Yellow
File
City
Contractor
TYPE OF STRUCTURE
Single Family
Commercial
y
Two-Family
Industrial
Public
Multi-Family
Other
Fee Schedule
/2d-
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
$39.50
$39.50
Lot Block Addition
Owner's Name Eo 6 C ('
Address L.j & Cf tJ (0 rd s s;I.
Heating Contractor 4/ k , L. I D
Address ;9rl-.(p' 0 /1l V(. <: ILI-OO.),J
9~~- C/Vo,3'177
edev--
N.C;'
Remember to add the State Surcharge on the bottom of this application.
Telephone #
Furnace Make & Model .I yJ ll.l:l.r;L"
Model Size . /00; 00 c) ~~3/ t.(
Conn. Load
Fuel;Jo.:I elf. ~ Flue Size
TYPE OF SYSTEM
Warm Air Plants
Gravity Additional inspections will be billed at $35.00 each.
Mechanical . House Heating Test Record must be submitted with buildinQ permit number before build-
Air ConditioningK-1 f'1I(\O<t A ,a9. cJV'd ing certificate of occupancy will be issued.
Vent. System
The price of your heating permit includes one rough-in and one final inspection.
Supply Openings
Return Openings
Input 10 O/~tJ ()
Output
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
HEAT CALCUI,.ATIONS 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.
Edr.
Other 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
447-9850
Cfm.
STATE SURCHARGE $
TOTAL PERMIT FEES $_
.50
9't?... 0 1)
Receipt #
37 11/3
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 of .~II.' w ~f.k k ': whhilch re ~~eVlew andj"pprova' of plans.
~ . O~~J .. /- ;;-P'GJO
'rj Appli nt's Signature Date
h..~ ----" s . 2.1- 2~
'- V' BjVding Offlcal's Signature Date
TYPE OF WORK
HEATING PERMIT FEE $
Replacement .Y
r .
. Est. Comp. Date
Building Permit #
.Jr:;. sO
New Construction
Alterations
Repair
Est. Cost $
#
TIME
CITY OF PRIOR LAKE
~NSPEC'fION NOTICE
J(J~df)
SCHEDULED
ADDRESS ~~ Lo~ CS;
OWNER
CONTR.
PHONE NO.
PERMIT NO.
O-Iro 7
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL A lAD" PLUMBING FINAL
o SITE INSPECTION lvr,1IJ MECH FINAL
<;(lMMI;NTS: ~ .,. *
UJ (iMJ.~ ~ ~~,r.JP
~Lrt - ~r-:\Au4l --:. k) ~tl w-~c;t~
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0- 4 ~ 2- Wu ~ +-; bf~ ~ ;~ C-
~'" r 1v~ 1u CA~c)- Cck~~
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.r-f. f\
CALL
R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOTl
-
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Job fZ;J/~,'l :54 ft, ~ 5
Heating Cdntractor ALTA, LTD.
HameofTester m~k
Date ~~ vo
~~'l 0.10
1 ~J'A
'7e~d
di~U
Percent O2
Percent CO
Percent CO2
Stack Temp.
Combustion air is adequately supplied per
UMC Sec. 606
Input
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