HomeMy WebLinkAboutMechanical Permit #03-1296
ADDRESS
3~91--
DATE TIME
SCHEDULED !J -!~ 3
4
/ p dfouJ taJcd S";-
CITY Of PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
/)3- /~9b
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
!' FINAL
o SITE INSPECTION
COMMENTS: ~~-
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~kIn~J.~
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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,
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C/tJ.5e -r;~(!
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
IliSNOTJ
CITY OF PRIOR LAKE, MC _
16200 Eagle Creek Av. S.E. Permit No. /J3
Prior Lake, MN 55372
HEATING APPLICATION / PERMIT
Date tJh~/{)3 . PID# ,;;l5~3o~- 011-0
Site Address 3 gc; I Wi I (() W WUl?d ..st". w. 1\ ,
Lot Block L-/ Addition Ii/ ~ P ~cto /S-t
Owner'sName--.C:hIAMJ Pm~ 0
Address 3gQ/w,9/()W Wf{)d~.tU
Heating Contractor , bV~ '11UtJh 1LIt?~
Address at? E Ci/IJ Wt:0 ~-11xJAn1t1 tu' ~33 t-
.' J' JL -
Telephone # 0~ - gqs - /qqJ.-
Furnace Make & Model1Yll.lhtL<!/ b'/!;I;O rlf(I/rYPE OF SYSTEM
U Warm Air Plants
Gravity
Mechanical
Air Conditioning _
Vent. System
Model Size
Conn. Load
Fuel
NI.-!".
Flue Size ~I
Supply Openings
Return Openings
Input 3'1-1 D liD
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
I
Output ?fA (5157)
Edr.
Other Devices
Cfm.
TYPE OF WORK
Merations
Replacement
Est. Compo Date
New Construction
)t> J J () 103
x
Repair
Est. Cost $, 2, 000 . l:J9 Building Permit #
HEATING PERMIT FEE $ 39 - S---o
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
J.../tJ . {fV Receipt #
?/S-3/?5
l~q6
1. Pink File
2. Green City
3. Yellow Contractor
TYPE OF STRUCTURE
Single Family
x
Two-Family
Industrial
Public
Multi-Family
Other
Commercial
Fee Schedule
REQUEST FOR FINAL
, INSPECTION SENT TO
, HOMEOWNER 11/03
1 % of job cost ($39.50 minimum)
$99.50
$64.50
C $39.50:>'"
$39.50
$39.50
y
Hesidential, AC Only
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 oermit 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 be in accordance with the approved plan in the
;;E;;;;;~h;;)~eW and appcoval of PI;~h
~ant's Signat?;i - t;J- ODtfetA3
Building Offical's Sign~re Date