HomeMy WebLinkAboutMechanical Permit 04-0064
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04.00rA- - TYPE OF STRUCTURE,
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-' ~ - ~ -. ' 447-9850
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TYPE OF W6RK ,I /<-t.tI/' J1 jL 5 vJ 1'f hereby apply for a mechanical systems permit and I acknowledge that the
., I , "'t.< V {.~ . / information above is complete and accurate; that the work will be in conformance
Replacement)l New Construction with the ordinances and codes of the city and with the state building/mechanical
I codes; that this formaoes not beco ermit until signed by the BUILDING
OFFICIAL; .Ill at ~ work will be in accord nce with the approved plan in the
casBlof alY'worl/' Which requires review a approval of plans.
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CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Perm" No.
Prior Lake, MN 55372
Date ,:)
S~e Address
Lot _ Block Add~ion .
OwnefsName 'TjI) 72.,,;.... ,." 'Tcz_ /0. C /l.-?
/ - " -
Address--.:/(~9(?-{] /:J//i6-~~~L, ~_I_C;L:- .
Heating Contractor (7". A h_~ Zc./ .f/..,t,. >4~ ]/7 '-
. - .'. - ':"':'0-
Address -2.!/11",,) - ~ :;y.,. 'A' ;__ _ i /-H-A ~')
T I h # Eck;) fi.-qjrbL/ h?",.:;J5S..7y</
ssp one ".' ___ . .-
-/O,~ -;' ,/1- /t:j ,,/'r
Furnace Make & Model ...&.~/'. /I TYPE OF SYSTEM
. . / Warm Air Plants
Model Size , J,' lJ.7 6 Gravity
Mechanical
Air Cond~ioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Conn. Load
Fuel
Flue Size
Supply Openings
/
/
Return Openings
Input
Output,
Edr.
Other Devices
Clm.
A"erations
Repair E. s}., Comp. Date
/:!>C/ A
Est. Cost $ / f(()I')(J ,..:= Builqing Perm~ # O<:t-, () 00'+-
. 6Q.- fV'~l&:
HEATING PERMITFEE $~ fl4-rN T VA/Irs J;
Jf. .~ /Jttr1!./t Bi/IL-~jA/& ~ /
TOTAL PERMIT F"-~ $ If'C.j '2;~ Receipt # ~ 44 "Y""J
, ,
STATE SURCHARGE $
I. Pink
2. Green
3. Yellow
File
City
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
$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 buildino. oermit number before build-
ing certificate of occupancy will be issued,
!::!EAI QALCUI A,TIONS R"()I """'1 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 SE 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
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
4&4,0
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
\i!:I FINAL
/0- SITE INSPECTION
COMMENTS:
SCHEDULED
~l-qL.+Do
Ih1~
I I
TIME
CONTR.
PERMIT NO.
d- ~&4
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
XMECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RJ
o FIREPLACE FINAL
o GASLINE AIR TST
o
c.~
Ft L.C
/'
~ORK SATISFACTORY
o CORRE~CACTI N A PROCEED
o CORRECT ALL FOR REINSPECTION BEFORE COVERING
Inspector: OWner/Contr:
I .
CALL "7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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