HomeMy WebLinkAboutMechanical Permit #01-1063
TOTAL PERMIT FEES $
'6--
Receipt #
STATE SURCHARGE
HEATING PERMIT FEE $
Est.
Alterations
$
s
50
Building Permit #
S-O
Cost $
Repair
L
Est.
Replacement
Comp. Date
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
of all ork which re . review and approval of plans.
Cfm.
TYPE OF WORK
Other Devices
447-9850
City Hall 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) -
CALL CITY HALL
Edr.
Supply Openings
Return Openings
Input
Output
Conn. Load
Fuel NirTL FlueSize~b&,,~
Telephone #
Address
Address
Owner's Name
Model Size
TYPE OF SYSTEM
Warm Air Plants
Gravity _
Mechanical _
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water _
Radiation _
Special Devices
business hours are 8 a.m.
HEAT.QA LATIONS 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.
House Heating Test Record must be submitted with building
ing certificate of occupancy will be issued.
The price of your
Additional
permit number
heating permit includes one rough-in and one
inspections will be billed at $35.00 each.
before build-
final inspection.
Remember to add the State Surcharge on the bottom of this application.
,Hi:TING APPLICATION
Date '2/)>16 PID #
Site Address 0bS"'2- GJ.
LO?/ ~ Block I
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
,XResidential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1% of job cost ($39.50 minimum)
$99.50
$64.50
r1~
~50
$39.50
B-1
Fee Schedule
Single Family
Commercial
I PERMIT
CITY OF PRIOR LAKE
16200 Eagle Creek Av. S.E.
Prior Lake, MN 55372
MC
Permit No.
o ffr.. 10103
TYPE OF STRU_CTURE
'\ Two-Family
Industrial
Public
Multi-Family
Other
1.
2.
3.
Pink
Green
Yellow
File
City
Contractor
ADDRESS
L( oS;)
DATE TIME
SCHEDULED /~ -/ ,,-/ 11:::.::(:
~(fLWl ~.
CONTR.
CITY OF PRIOR I..AKE
INSPECTION NOTICE
OWNER
PHONE NO.
PERMIT NO.
/- 1063
o FOOTING 0 PLUMBING RI I EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP ~IREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
o FINAL 0 PLUMBING FINAL GASLlNE AIR TST
o SITE INSPECTIO~ 0 MECH FINAL "-
COMMENTS: r,!~ ~ [YJz~ ) .
lI47-J~~7 ..~~r~
. .~!;,~""'
('j~.:}~~
.'. ,~~~~14\i
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. ~ Owner/Conlr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI