HomeMy WebLinkAboutMech Permit 03-0162
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUlEO
ADDRESS
If 7t!
,;c..
6y(/l'C(1
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL /
Fv.,~.tr / 4- ~
/ ., I
I
COMMENTS:
/ / /1\/
~vd --
. -
r=;tp
t . -
DATE TIME
J.-2tj
3 -( C 2.
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
//))
(f1/
r, WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: l,~t1 ~- 't l..f --If'> Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
lNSNOTl
AODR ESS _
OCCUPANT
HEA T LOSS
SOLO BY
EI.ch;col Wo,k By
TYPE OFHEAT GA
DATE HTG. INST.
FA _HW _
GAS ~ESIGN
MAKE LA-RRIEfl
Mod.1 ----5vc.tA Om J/2
s..rio I S "/LIf) ~ Q 3" S'IO
INPUT 10,000
THERMOSTAT
Volv..
Litr.'t
Limit Selling_
Fan ~"ing
Pilol T yp-e
Pilar Mol._
Pilot Mod..l
Pilol Timing _
L.W. Cvl 011
Prel'lure
'3' ,5
I~pul CFH
Slack T..mp.
J~
CONTROLS
Heo' Plvg _
P..'cen' C01
P~rcenl 0
I
Pe'cen' CO
HOUSE HEAT'HG TEST RECORD
'l,/
1,0
o
_ CITY
SUBURB
_APT_ _FL.oGR
_OWNER_
STEAM
_\I~STALLEO BY
_ Go. line By
SPACE HTR.
UNIT HTR.
. OTHE R
CONVERSION
MAKE OF BURNER
Mod..1
. Mox. 8TU Roling
. MAKE OF FURNACE
Modal
Ven' Sil.ll!
NONF
KINO OF Llr~ER_
. SIZF
D,oll Hood
F;II..,. Sin
Chimn.,y Location
Chimn-ey Con$fruc'fOn
Regulator
Numb.., _
In.id... Oul,id.. -
Smok.. Bomb _
0,011
_ Wiring
.Tul T09
Door Pres sure
. Lighling In'"
Do'.. T...,..d .::J-O{p-o'~
Company T...I;ng c4-uNilllJ.;- AK_
~lom.. 0' T...,.., ~T~
...--
CITY OF PRIOR LAKE #590
HEATING/AIR CONDITIONING/FmEPLACE PERMIT
(Please tvVe or orint and sil!ll at bottom)
ADDRESS
/&7// LvolJJ Ave, S,&
I
LOT BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
((};~hel/e cY(~hmif-f
~ aa cYi~
AdV(J J1+a~ /Ju-VI /rw.
(g ':]/5 /86H/) Sl tA)_
(Contact Person) ftil;/!;:':;'~ / ~,-/J
__APPLICANTSIGNATURE / 1{)I~/?7;'~
/'
APPLICANT PLEASE COMPLETE BELOW
/'
DNEW CONSTRUCTION ~PLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL{!arf'7i~ 3'?C rAO'?o II/A FUEL IJa....f
FLUE SIZE 5 if RETURN OPENINGS 0 INPUT-Je} (X) 0 OUTPUT50 000
TYPE OF SYSTEM HEATING OR POWER PLANT
~Wlirm Air Plants 0 Steam
OGravity 0 Hot Water
o Mechanical 0 Radiation
~ir Conditioning 0 Special Devices -
~ OVent. System , . 0 Other Devices
HREPLACB MAKE AND MODEI('~ 2:> 7) ~ ?-J~O 8--Y-2:) d--t&~ -k L G
OWNER
(Name)
(Address)
APPLICANT
(Name)
(Address)
Date Rec'd
J. Pink File
2. Green City
3. Yellow Applicant
PERMIT NO. ()?;-' It:,M
ZONING (office use)
)1.15 D
PID~5- OI1'03~-()
(Phone) 954- tfY?-/909
(Phone) 95 d - C) 'IS - /90 0
(rJ7CUc\/.A?fl ,llIA/ 65379
(City)' r (Zip Code)
(Phone) 9S'c9 -</</5- /9{) a
DATE ell( _0 )Lo~
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
~
i'1"-J'\f-... '6V
Estimated Cost $ "1\..JvV' ./
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
$39.50
$39.50
$39.50
Building Penn it #
$ (jq ICP
$ .50
$ L-H'). ()::)
Paid j h ---
to ..
Date
(:) ..1 /' ()3
Receipt No, .. I
q3/74
By ~
(J