HomeMy WebLinkAboutMechanical Permit 04-0121
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CITY OF PRIOR LAKE
16200 Eagle Creek Av. S.E. Permtt No.
Prior Lake, MN 55372
04-.012,
HEAnNG APPLlCAnON I PERMIT Id- /
Date 3\ ~ \.0() ~ PID.---z5': OOf. ooS. /
stteAddress.\ \o~\o"\ ~" ~~~r-.. ~~~
Lot _ Block Addttion
Owne(s Name ~Q... ~ " <::... "'"' '1'\ ~"-~, '" ':\. 0.......
-
Address \ '-0 :;""'vI""\. ~v IV-. <:::.. ~-<'\I'- ~ _.1)
Heating Contractor ~~" Q.. -\....t. '-<(.\> "~Q-'" ~\ ~
Address ~ ",\ C\.. 'oJ e ~- ~ ~
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Telephonel 0\. '5~- '-1\ ",,:;,- '-J... -:.... 'J-2
Furnace Make & Model
TYPE OF """,en!
Warm Air Plants
Gravity .
Mechanical
Air Condttioning
Vent. System .~............~....rk \-s
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Model Size
Conn. Load
Fuel
Flue Size
Supply Openings
Return Openings
Input
Edr.
Cfm.
Output.
Other Devices
TYPE OF WORK
Atterations
Replacement
New Construction
Repair
Est. Cost $
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
Est. Comp. Date
Building Permtt. .
--::z.....o.. ~~
.50
\>.. ("',40"> Receipt.
04-.012.1
4f,Z7(P
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1 ~.t.
File
City
Contractor
TYPE OF STRUCTURE.
Single Family
Commercial
Two-Family
Industrial
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 01-0S
ngg....._.___
Residential. Additions & AtteratJo""
Residential, AC Only
Public
Multi-Family
Other
1% of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
(J39.5O)
$39.50
Remember to add the State Surcharge on the bottom of this application.
The price of your heating permtt includes one rough-in and one final inspection.
Additional in.".~~;;~ns will be billed at $35.00 each.
House Heating Test Record must be submitted with lll.Iik!ing Dermit number before build-
ing certificate of occupancy will be issued.
I:IEAI CALCULATIONS REQUIRED wtth number of supply and return openings listed per
room with CFM's per opening. New structures or additions send floor plan with supply
and retum 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.
Ctty 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 all work which requires review and approval of plans.
~\'"' \ \) ~
Date
..3. 6.64-
Date
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEOULED
D~~ / TIME
~aJ./
ADORESS
/6.20 / ~qH<5h---- ~~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
Lj. I;} I
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~CH FINAL
COMM~lffs: I /
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// eh :h r / q.- 756tt-- S;>($-- ~.r-...
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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kORKSATISFACT~
o CORRECT ACTION AND PROCEED
o CORRECT\voR~'ifJR REINSPECTION BEFORE COVERING
Inspector. /' ~y Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOT'
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!