HomeMy WebLinkAboutMechanical Permit #00-0279
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No. 00 -0 ~ 7~
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
Date ~rho PID# 7&;...25e- Oz..Z-O
/ /
Site Address ::J' 7 75" //~ ,lG;V/7 ~.A~ / /<./
Lot.3 Block 3 Addition ~,P. etJ)~g /s::r
Owner's Name~rJ.l to:'VCt/l-/pS,C..z
--./
Address
Heating Contractor 5'rA-r~..:rO~5 s:.eU1<CJ!'S
Address ?:?'/.2 ;Z~A;? .,9 .5:"JJ
Telephone # /'iC/.;:V 9'Y7- 7/F ~
, ./
Furnace Make & Model ,#A /.~C
-.{
Model Size.fl"C 0 V '?d RN
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~$ Flue Size ~ '"
Supply Openings
Return Openings
Input;?.9:L.JLJ Output
Edr.
Other Devices
Cfm.
TYPE OF WORK
Alterations
. Replacement
New Construction
Repair
Est. Comp. Date
Building Permit #
tiJ - 0 lL1f
Est. Cost $
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
Receipt # .
313~ 0
TYPE OF STRUCTURE
1. Pink
2. Green
3. Yellow
File
City
Contractor
Single Family _
Commercial
Two-Family
Industrial
Multi-Family
Other
Public
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 PLEASE NOTE:
$39.50 Air Conditioner Units Cannot
$39.50Encroach Into Required Side-
$39.50Yard Setbacks.
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 buildinq permit number before build-
ing certificate of occupancy will be issued.
l::lEAI 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
447-9850
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;.1J:ta1l the work will be in accordance with the approved plan in the
case of aH'wo.tk1.vhich requires review and approval of plans.
'~ ~L
AP1J};Pica1. g;;ture /~a
. If A V,- 4J Z,
Buildi .~'l"Signature ate
~ . crn- OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 39.7 ~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS@
~*
DATE TIME
SCHEDULED 5f..4/ ~ () 9: 30
HIODEN fb,..;o TiL.
CONTR.
PERMIT NO.
00 -DZ-79
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
~ g FIREPLACE RI
o FIREPLACE FINAL
~ GASLlNE AIR TST
~(!~~
~~
~ ~ ~ ;2LA.-d~.
- ,,1/ A __./.11 l
~ - <:...J'.';.~ ~_:;'Z"n ~
, Z,S::J&- A:r I J_ ~- I
o WORK SATISFACTORY, PROCEED
tCORRECT ACTION AND PROCEED
::o:ECTWO~ FOR REINS:~::I::FORE COVERING
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl