HomeMy WebLinkAboutMechanical Permit 01-0258
r CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No. 0' -D ~
Prior Lake, MN 55372
HEATING APPLICATION / PERMIT
Date 4- ?, --0 I PIO # 25 -Zfo~ - OOq - ()
Site Address \ Y 3 <DC( F( 5Mf fJn;. rJ~> E _
Lot ..!1..- Block , Addition NOen-\ ~DeE.., OA.K.5 ~-n-t
Owner's Name 6~ -\- Av\~S.O "..)
Address
Heating Contractor 00('(\ S V\ \ \f) ~ti f\{\ '* 'A ( c...
Address \2.l\. <6 \ (2 ho~ '--~ \CU"\O- ~. $ ,
Telephone # '1G-2,.- )$>q q --OCO$""
Furnace Make & Model
AIR CONDITIONER' UNITS CANNOT
ENCROACH INTO SIDEYARD SETBACKS.
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Other Devices
Model Size
Conn. Load
Fuel Flue Size
Supply Openings
Return Openings
Input Output
Edr. ,
Cfm..
TYPE OF WORK
Alterations
Replacement
New Construction
Repair,
Est. Comp. Date
Est. Cost $ .:2000.00 Building Permit # 6' - 0 Z5f?
HEATING PERMIT FEE $ 99 ~ ~O
STATE SURCHARGE $ .50
TOTAL PERMIT FEES $ L-{ 0 . lID Receipt # 3933t!J
TYPE OF STRUCTURE,
I. Pink File
2. Green City
3. Yellow Contractor
Single Family, ><
Commercial,
Two-Family
Industrial
Public
Multi-Family
Other
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
C'$39.SCr- '/
$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 $35.00 each.
1-/,." ,c>o I-/o~.in" Toc>. Co,.."rrf ....."C>. ho C>I,h.....i..orf \&li.h h"ilrfinn nor.....i. n',.....hor hof"ro h"i1rf_
I ."'''''''''''' I I,",""'"I~ ''''''~L I "",\JUlY IIIU~L UV ~UIJIIII""U WWUII LlUIIUIII':t f-I\JIIIIIL I ILlI I ILl"'" """'V''-' """"'11\",1-
ing certificate of occupancy will be issued.
HEAT CALCULATIONS REQUIRED. with number of supply and return openings listed per
room with CFM's per opening. New structures or additions send floor plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Phone: (952) 447-9850
Fax: (952)447-4245
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case Of:" wor~h~h requires rU approval of plans.
Y-(. f!,.{~ .L..f-2-ol
AppliqtV t'~igl,ture - Date
4-5'-0
Date
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
t 4 J8'c{
hln~~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
f '-VIA. (.-;
COMMENTS:
(~~QSC:
DATE TIME
7-/0
Ac~
.."
A\'O~)$"
-
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
;(WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOi7 CALL FOR REINSPECTION BEFORE COVERING
Inspector. /4'" J - {O~ ONnerlCornr,
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
I1I$NOn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!