HomeMy WebLinkAboutMechanical Permit 01-0227
ADDRESS
/l/{'7~'
DATE TIME
SCHEDULED rg- -/0-/ I;, / t"
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CITY OF PRIOR LAKE
INSPECTION ~TICE
CONTR. F P
~,..~' '7 ' .
PERMIT .' ,. - r,. 1'"0' ~ 12~
-~ ~ . - -'::-;
o FOOTING .,", P PLUMBING RI ~ 0 EX/GRAD/FILLING
o FOUNDATION ~ MECH RI i i - 0 COMPLAINT
o FRAMING ' WATER HOO ~ I 'II} 0 FIREPLACE RI
o INSULAT~i ~ SEWER HO Pr5JIl)~IREPLACE FINAL
-rr1=INAL JJ (. - PLUMB I , INA iP 0 GASLlNE AIR TST
o SITE INSPECTION . 0 MECH L 0
.~.,<.~"'....
OWNER
PHONE NO.
COMMENTS:
('
,..,
~WORK SATISFACTORY, PROCEED
( 0 - CORRECT ACTION AND PROCEED
o CORRECT WOR~LL FOR REINSPECTION BEFORE COVERING
Inspector: ;~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTJ
O'-OZZ7 ~
Single Family~
I\Y, 4:LYt; L;tJ~~
~~~. Crr.v OF PRIOR LAKE
u r.> t, 16200 Eagle CreekAv. S.E. Perm~ No.
~ Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
Date ab-YJ/O} PID#2S- 300-040- V
Site Address 1<-e6 7 ~ &N' j ~ Lr-J
Lot 4-- Block (P Addition ~/1tf16 If/{,(.,-J :;?I!:P
Owner's Name i3 ~ y II ,..~ I /'/1 It:? fI CU-\..,~ I/"fl y ,,1lJ;.A
Address h 6) -) (IA"~ ~{}JL LrJ 01
Heating Contract~r J/ ~~ P B>l~P~;_ .
Address I b / 2-1 rn,€J ( /'...1 /tV ~.. ,r;;R--i D "'--- ~-
Telephone# . QS2.... '1"-1'0- ~~
pv~(3~~rJ -
Furnace Make & Model ~ ( LA:-- TYPE OF SYSTEM
, .~. . _ . _ Warm Air Plants
Model Size 3 t:, ~-.t...s (:>00 I ,,-l p.." ( Gravity
Mechanical
Air Conditioning / /..
Vent. System rnn::rr..g-7) C-.. 'I; 7
Conn. Load
Fuel
Flue Size
Supply Openings
Return Openings
Input
Edr.
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Output
Other Devices
Cfm.
Alterations
:;(
TYPE OF WORK
Replacement
New Construction
Repair
Est. Cost $ ~3-0-o
Est. Comp. Date
Building Permit #
()/ - O-Zz, '1
/
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
;:J9..'-:) -D
.50
~ Receipt #
313Z/j
TYPE OF STRUCTURE
1. Pink File
2. Green City
3. Yellow - Contractor
Commercial
Two-Family
Industrial
Multi-Family .
Other
Public
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only_
Residential, Gas Firepla~~
Residential, Additions ~;ations
Residential, AC Only
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$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 building oermit number before build-
ing certificate of occupancy will be issued.
ttEAr 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 will be in accordance with the approved plan in the
case of ~on.k which requires revie: a~d approval of plans. . _ .
d---e~ (3~~, 3> '-~<4 d (
~ Appl" nfs Si~~b ~
( g ff~ Signature
Date
3-2,f. 0 I
Date