HomeMy WebLinkAboutPermit 4102B11
APPL._ATION FOR MECHANICAL PERIII.. .
SCOTT COUNTY, MINNESOTA
TownshipfQly
$L
Permit number
Receipt number
~cJz.-I5-/1
/55i'7_::S
- - - - - - - - - - - - APPLICANT FILL OUT INFORMATION BELOW: - - - - - - - - - - --
Project Address
1'l1.:2S- iY\&..rl.. 1-......
(Leave blank if address has not been assigned)
~f':,\) r- LA k~
Twp/~
City
Applicant
-----
State~
Zip 53'1;;:).<,
Phone (Home)
(Work)
Address City State Zip
Owner (if otherthan APPlican.)\\:.,lI i cl ~;)a.~t.. Phone(Home) 1../-4.0 -Ltf')OL.(Work)
Address III J..5 ~-\l \12... La. Y\ -e.....; CityPr'\ Dr LQ k~ State fY\ T\ zip...5fi 2ll L.
Contractor Nam-;-T"C)-ta\"~ r, -:I"'nc.. Phone (HO~) (Work)$(Cj Lf-l 'i12.
Address \ '1.l~ lJJ 'c..~\l~S~i\ \'L --VkW\ c1tyD\.tr{\S~; \ k State m f\ Zip 55331
Project Legal Desc. Parcel No.
Section _ Lot _ Block _ Subdivision Name
CHECK APPROPRIATE ITEMS BELOW
BUILDING TYPE: Residential L Commercial Other _..l cll
V i f"\S-TQ\ \ -\-r'e"\:.Sft\l\~1'I/
NewConstruction_ Akeration~ Replacement_ Add~ion_ Woodstove_ Otherr"\a-\-',qqs. <J
,1.; r~~j\o.r" )
FUEL TYPE: Natural Gas X Fuel Oil_ Liquefied Petroleum _ Wood _ Other l J
FORCED AIR FURNACE
MAKE:
BTU'sfTONS:
AIR CONDITIONER
*1 ton equals 12,000 BTU's
Round total BTU's of the
TOTAL DESIGN HEAT LOAD
BTU'S
FLUE TYPE
furnace & A.C. up to the
VENT SIZE: next 10,000 BTU level.
LIST IN DETAIL TYPE OF WORK BEI:l~:~RMED ---L (\ s -t ~ C \.J\>JU\ C\~
,,_\.~ ,,~ \ 0i~^~ {\crt C\o.:3, -.s::,---\-cY.r.~
'U U ""\ \\
Total value of work performed:r .2 (,,0 0 . D 0
I hereby agree that the work for which this permit Is Issued shall be performed according to the approved plans and
specifications, t~DDII:"18 ~Ity ~In\nces and !,t'e M~nnesota State Mechanical and BU~din9 :odes.
Applicant Signaturp - ~ \ U~ Date 11 10 CJR
- - - - - - - - - - - - - - - COUNTY BUILDING USE ONLY - - - - - - - - - - - - - --
REQUIRED INSPECTIONS: Rough-in and gas piping air test: yes _ no _ Orsat and final: yes _ no
Other
Approved ~ Denied _ By Building Official subject to existing regulations and the following conditions:
---.J~/...
t..4 Mill A./vtJ.
YhAnct9JA-'.
?;J A~t:""'" _C: ~ ~ _ t:../)IJ'C-
.
SIGNATURE
~""". M/hL...C
Date/::1.- Jq- 9~
ADDITIONAL COMMENTS:
FEES: Permit
Plan Check
State Surcharge
TOTAL FEE .40.50
06600.2821 (4.91 500)
White - County Yellow. Interoffice Pink - Applicant
COUNTY lJ. ;COTT
INSPECTION NOTICE
Lj IOd--.{3-;/
...5L
17/..<5
PHONE: 49&" _~34 or 496-M75
DATE TIME
SCHEDULEDj~-I.1-'1 f /)'!j
COMPLETE ---.:::/ f14'r I' () (/
Plofl... Lh
PERMIT NO.
TOWNSHIP/CITY
ADDRESS
OWNER
CONTRACTOR'
W/'110t't..JI
I
72> T.. /
AIr-
>.
>-
'"
"-
""
U)
a
<:
""
:t
>-
..,
""
'"
:t
..,
""
<:
a
U)
ex:
'"
Cl
ex:
:::>
a
>-
ex:
a
"-
'"
ex:
""
U)
>-
<:
'"
::;
'"
ex:
:;
o
'"
ex:
'"
a
a
o FOOTING
o FOUNDATION
o FAAMING
o INSULTATION
o WALL BO
o FINAL
o PROGRESS
o DEMOL
o FIRE PREV
o SITE INSPECTION
o EXCAVATING/GRADING/FILLING
o LAKESHOREJWETLANDS
o COMPLAINT
o FOLLOW-UP
o FIREPLACE/CHIMNEY THROAT
~IREPLACE-CHIMNEY FINAL
GAS LINE PRESSURE
o
o PLUMBING AI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o SEPTIC MAINT
o SEPTIC FINAL
o PLUMBING FINAL
COMMENTS:
_ '1r (1./ .1
f'-j Y '7 I
A- I I
(
d~
// \."
~ ~\~
../
\
I~
"'
PROJECT COMPLETION DATE
RK SATISFACTORY PROCEED 0 PHOTO TAKEN
C REGl WORK & PROCEED
o CORRECT WORK CALL FOR REINSPECTlON BEFORE COVERING
o CORRECT UNSAFE CONDITION WITHIN __~_ HOURS, INSPECTOR WILL RETURN
o STOP WORK ORDER POSTED CAll INSPECTOR
o INSPECTION REQUIRED CAll TO ARRANGE ACCESS
BUILDING INSPECTION OFFICE
Courthouse A102. 428 S. Holmes St., Shakopee, MN 55379
Call for the next inspection 24,ours in advance
Owner/Contr, o(o)s.te
Inspector \ ;ll.{ j /'~ Ql/l
06600 2807 (697 5M) White Copy ~nspeclo~r s F4J Canary Copy RecordS
Pink Copy/Site