HomeMy WebLinkAboutMechanical Permit 01-0134
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CITY OF PRIOR LAKE MC
16200 Eagl!! Creek Av. S.E. Permit No.
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
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~- \).1..o-b\ PID# z5-Z35- 00/-0
Site Address. '2, d.~D LA '\\d.~ ~'f'~ N. \_.'1 '
Lot / Block / Addition
Owner's Name ~~ ~Ovr"~ ~(J '\ \ ~,d
Address ~('k-'{'\~ (~ ~ ~\ ~
Heating Contractor ~~B- ~\("' , \ ~ ~
Address ib~~ \~ ~~ W. ~~C\.J~0s<-~
Telephone # ~~--\ q ~~ .. .
Furn~~ 'Sbrx, ~(4oeo TYPE OF SYSTEM
6J-~ " ...,...,' Warm Air Plants
c.>--\ <::>0 a Gravity
Mechanical
Air Conditioning
Vent. System
Date
Model Size
Conn. Load
Fuel
~t~Flue Size
Supply Openings
HEAnNG OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Return Openings
Input Output
Edr.
Other Devices
Cfm.
Alterations
TYPE OF WORK
Replacement .x. New Construction
Est. Comp. Date
Repair
Est. Cost $
01-0/34-
Building Permit #
'bC\ \ '2C?
.50
4b~to ReceiPt#-39057
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
TYPE OF STRUCTURE
1. Pink
2. Green
3, YelIow
_~1~9/
City
Contractor
Single Family
Commercial
~
Multi-Family
Other
Two-Family
Industrial
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
$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 puilding permit number before bui!d~
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
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; that the work will be in accordance with the approved plan in the
case of all wO<k WhiChreqUires[~ approval of plans. ';;)-/ ~ /6/
~ Dme
3-/-()/
Date
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
"
ADDRESS
32~
L I/J.J)EJJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
Pr jif'MECH FINAL ~
rF::~~
f,J.:;~'
Oi,,-
.e"
DATE TIME
3//9(01 kg()
LIe I
()1-/3L{
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
./
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~O~~, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ,_')" \)~ Owner/Contr:
CALL 447-9850 FOJTHE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI