HomeMy WebLinkAboutMech Permit 02- 860
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CITY OF PRIOR LAKE MC
16200 Eagle CreekAv. S.E. Permit No.t)~- gtoO
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
Date 4 jJ .en.. PID #
Site Address \to.3 \ \ D\.)\,~ .sL
Lot Block Addition
Owner's Name S\ lv\ \D\~\1:.~.s L~\)'U\
Address l ~3 ,\ 'D\)U)t~ ~vt: stl
- ....,
Heating Contractor ~~~~\~ ~
Address i4.~2... wf:\..\\\,t.\~ '\ I\'\X: s.
e'5'"~~- 1I,~~ )
Telephone # _ _ I' ~~'L-~\" ~
Furnace Make & Model .lezriYPE OF SYSTEM
Warm Air Plants
Model Size \U) ~~ Gravity
r
Mechanical
Air Conditioningt~') S~ ~~
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Conn. Load
Fuel~lueSize 3\\O~
Supply Openings \ L
2. t.~,_
Output \ \D~~
/
Return Openings
Input .lZJX)~
Edr.
~. ..... ,~(./ Other Devices
Cfm.~ ,.~"""
TYPE OF WORK
Replacement _ New Construction .x
Est. Comp. Date ~.OI.. .
G.>
Est. Cost $ 3D, z.z..s - Building Permit #
HEATINGPERM~FEE$ 30~
.50
30 L~ Receipt # qd<S'15
Alterations
Repair.
STATE SURCHARGE $
TOTAL PERMIT FEES $
~ " f'"
1. Pink
2. Green
3. Yellow
File
City
Contractor
TYPE OF STRUCTURE
Single Family
Commercial ~
,
Two-Family
Industrial
Multi-Family
Other
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
$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 building 12ermit number before build-
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 e in accordance with the approved plan in the
case of all work which re es review and approval of plans.
_(0' r~' t)l-
. . Date
i /" 'eJ 7-
DJte
~-:>",...-
CITY OF. PRIOR LAKE
INSPEeTION NOTICE SCHEDULED
.: ( (
ADDRESS /~~~O J)Ju,th
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
~LUMBING RI
ECHRI
WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE I TrE ^ II
~-M-bJ.. ~
();).- ~~D
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMME~TS: \ \
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o P",Ol'~ . /
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ftORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR_~. CALL FOR REINSPECTION BEFORE COVERING
Inspector: '1> -U.tLAAi( Owner/Contr:
CALL 447-9850 FOR ~HE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl