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_______ --- ___---- --- . .._._.. ..__...._. <br /> _�` FOR CITY L�SE O�Z�' <br /> � Cih•of Oivno z <br /> , �ON` � P.O.Bos 6b Date Received: ���(�Peimrt� l��'"�'�' ✓7 <br /> O � �?SOKeIIeyPari.-�vay �,( <br /> �� � CrystilBay,i4[Iv 55323 Appro4rd By: � Amaurt$: �� � <br /> " � �� � Phme(952)2�9-4600 Fax(9i�)�49-4616 /y�Q <br /> 1�\I � ) � , ' �j�'J <br /> ��`��� �`'/ CITI OF OR010-MECHA�tiICAI.PERl�'IIT �� <br /> \��f.�t{���t� (pllConutrrcialpmnits mist be approved by'the Build'a�Oflicnlor Inspecta az�dor Fia�iarshall,l <br /> ---------------------._._.__._._.-----------------------------------------------�._.__Y____ <br /> GENERAL INFORMATION <br /> 1. 1'ou may appty for inecharvcal pemvts by nn�1 or n person at tl�e Ci[y offices. Applications«��1 <br /> be reviewed arxi a pernYit«�ill be isst�ed wiitun hvo�vorkuig days. <br /> 3. Pemiit cards�villbe sexu Uy retum n�il a$er a ce�����is con��ted. PERI�4ITS ARE NOT <br /> �'ALID UNTIL 1 OU RECEIVE A PERMIT. «'ORk�IUST NOT BEGIN LT'TIL THE <br /> PERMIT C�RD IS POSTED ON THE JOB SITE. <br /> 3. Mechanical Desisns—Coix�letz ca]culatiom.deta�s ar�d specifications are requu•ed for each <br /> heating,��ent�atmn,lnut�if�at�trdetnuiridif�ation,and air coixiiti��installatmti inc�xdir� <br /> t�at]oss/heat gam calctilation,design ten}�esatw�es,eqt�ment ratings and icientific<�tioxi as to <br /> type,matnz6cturer atxi imdel Data shallbe presented on fomi pro��ied. <br /> 4. �L'hen any i�e�u conshZu:t�n or renx>del'u�g is ai�lved,a separate building pernvT nnut ve <br /> obtau�ed. <br /> 5. All�i�ork irust be done in accordar�ce�a�ith tl�e Uniform Mer.haz�al Code/State Bw7du�g Code <br /> requffei�nts. <br /> 6. All��rork rrust be u�spected(inugh-n and fnan. CaII(952)349-4600. <br /> (24-48 hournorice irquiird) <br /> 7. House Heat�g Test Record must be subimtted before frial <br /> T'1'PE OF PERMIT <br /> _ �Checl�AIl That Apply)___.__.. <br /> -- -- -_____ - --- ----_ __.,_._ .,___.�.._.__. <br /> �Residential ❑Coirnl�ercial(ApprovalRequired) <br /> ❑Ne�v ❑Additional ❑Rtpairs ❑Replace <br /> � Job S fe!O�vner Info�nation: ( <br /> 3� a s �'�.�. �� <br /> S ite Addr�s s: � <br /> O�vner:� �•S G� Y' „� Ma�ling Address: �7� J�t�15���� <br /> C�y: �d��nC� Zi�: 5 S J � � <br /> Home Phone: (�I a-��� S 7 3 3 Alten��te Phone: <br /> Contractor Inforn�ation_ ��� � �1 <br /> Contractor: <br /> C,,�� U;e� F I b��� I�C� Contact Person: Q�,�v, 1-� �� ���CtY•� <br /> Address_I��B �i We3��10.�2c��"ct�j�v'�1 Stat�Boud#: ����j v1� � <br /> Cty: �rr►�►,c- Lc; l�c� Z�:.�53SC�EYpirltionDate: � � ?�)� <br /> Pl,oIlz: 9s 2-y�3�S7�� Altemate Ptione: 6/e�(��5 �L�IL� <br /> ❑ It�surance-Ctirrent: �P__� <br /> 1 <br />