HomeMy WebLinkAboutMechanical 99-1359
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS I L.I Y l 'f
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
_ Il"l \c1
SCHEDUI"ED
l^.>~.s~~<
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~UMBING FINAL
~ECH FINAL@
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TIME
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
""
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~
Owner/Contr:
CALL 447.~"50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
1. Pink
2. Green
3. Yellow
File
City
Contractor
CITY OF PRIO,.R LAKE MC ,
16200 Eagle Creek Av. S.E. Permit No. qq-l3GlJ
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
Date //-/0 '75 PID# 25-1 \Cj- ()2.8-0
Site Address J '-I~ /9 Lu~~ J - '-n-r?
Lot gz. Block Addition -{3CUDlt-JS f-1A./\!OR.
. "'-----
Owner'sName '-I77...i)'({:> i-~
Address / t./ l//Cj W C/ r;- ~'" J _ .>? /"
Heating Contractor'"BI~ ..1dL.-/", ci.Ie~ P1/' cr ,i// k
j -
Address / CW it ~ at ~/lif-1.~"r/.. r
Telephone # J I ~ rft9 (,/" COO 0 (--
TYPE OF STRUCTURE
)(
Single Family
Commercial
Two-Family
Industrial
Multi-Family
Other
Public
Fee Schedule
1 % of jo
$99.50 ~'1~n ~n~mum)
$64.50 ) r-~.l~ :I~'
$39.50 . ( -- .
$39.50 \ \ f<<)V, 2 It'Yl
~ U. ,=9
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
Remember to add the State Surcharge on the bottom of this application.
TYPE OF SYSTEM
Warm Air Plants
Gravity Additional inspections will be billed at $35.00 each.
Mechanical House Heating Test Record must be submitted with buildinq permit number before build-
Air Conditionin~~~#/lI;U1;'iI. ing certificate of occupancy will be issued.
Vent. System /I ;).70h
HEAT CALCULATIONS REQUIRED with number of supply and return openings listed per
HEATING OR POWER PLANT room with CFM's per opening. New structures or additions send floor plan with supply
Steam and return locations shown, HEAT LOSS CALCULATIONS, PAYMENT AND
Hot Water APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
Radiation CREEK AVE. S.E. PRIOR LAKE, MN 55372,
Special Devices
Furnace Make & Model
The price of your heating permit includes one rough-in and one final inspection.
Model Size
Conn. Load
Fuel
Flue Size
Supply Openings
Return Openings
Input
Edr.
Output
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
Other Devices
Cfm.
TYPE OF WORK
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 w~equires review and approval of plans,
\M~~
Applica~!S Sign~Yjc-J-..i '
_. ,/t79 '~.
\JIl c~re'<~
Replacement )(]
( -
Est. Comp. Date
New Construction
Alterations
Repair
QQ-I,3,-5Q
.. U /
Est. Cost $ Building Permit #
HEATING PERMIT FEE $~ ~ . s-o
STATE SURCHARGE $ .50
,,/ pC)
TOTAL PERMIT FEES $ -r-tJ Receipt # .
11-10 -75'
Date -
11//9/qq
, Dat'e
~537
,
97~S-6~V