HomeMy WebLinkAboutMechanical 03-0428
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BVRNSVILLE
Heating & Air Conditioning, L.L.c.
12481 Rhode 1sland Ave S, Savage, MN 55378.952-894-0005
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Orstat Test Report for Jobl ~ 0 ?,
Address / (n 5) 'T /'c; Jk.. O/,~ (j-,; ,:~ I q;('~
Occupant //{, f- C,,/, fie. {~
Date of Install Ii -/ 1~ 0 5, ,
Type of HT. F/A;( HW Space HT _ Unit HT
Other I
Make
Model
Serial
Input
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G (, i L-t -N O~j3 If) 7 t)
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Pilot Type
Pressure
Input CFH
Stack Temp
HOT SURFACE IGNITOR
j, S C02
? [J _ (l ~~ "'I~ , 02
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'b' . (",
to ~ y
0"
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Date Tested
Company
Technician
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BUR1jBVILLE HEATING & AIR CONDITIONING
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
I G '37l.( (:)vt /h.r
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
COMMENTS:
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DATE
TIME
4-1'-/
3-4L~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
~IREPLACE FINAL
~ASLlNE AIR TST
o
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECTl~' CALL FOR REINSPECTION BEFORE COVERING
Inspector: r' r L1.... J.44> Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~~n ~~~. I PERMIT NO,3-I j~ {)I
3. Yellow Applicant .., c:r-o
(Please type or print and sign at bottom)
ADDRESS
I b31 if
~ o.,{ .L
Ov\fti
I ZONING (office use)
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LEGAL DESCRi.t' nON (office use only) ~ .
LOT(~BLOCK L{ ADDITION~UJZcU rWV
OWNER
(Name)
PaJ () ( h a r /J..
<5MvLR
PI~ 5-oQfo- COd.--O
(Phone) !J)~ -Cllf7 ,-(~57
(Address)
APPLICANT
(Name)
(Phone)
~~rns\!iIIe Heating & A/C. In~
12481 Rhode Island Ave. So.
(Address) ~a"a!:'Je MN 5~~7Q-1122
(Contact Pefflon) " j ~l Z I M;,..) (Phooe) (~ - ~'1lf ~ZiO {)2;
i\PPLICANTSIGNATURE -C}W (1, lAAJJ7MJY1 DATE L/ / (01 0 ~
j\PPLICAN-ULEASE COMP~ETE BELOW
DNEW CONSTRUCTION ~PLACEMENT 0 AL TERA TION~ J^-.1
FURNACE MAKE AND MODEL L.u1 (It))( G ftJO u H . ~ !flPFUEL IVUJ>', Q4.5
FLUE SIZE RETURN OPENINGS INPUT 3D. 0lJD OUTPUT ~() ()
, .
REA TING OR POWER PLANT
TYPE OF SYSTEM
DWarm Air Plants
OGravity
o Mechanical
g.\ir Conditioning
OVent. System
o Steam
o Hot Water
Ltf'lM7( 0 Radiation
'13 AGL-Q;SO 0 Special Devices
Z;: I z.;Io f)O Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & AIC (New Construction) $99.50
Residential, Heating Only (New Construction) $64.50
Estimated Cost $ ~ 00
$39.50
Industrial, Commercial & Multi-Family
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
'5q,~
. . ~ .50
4{J, Q[)
,
lice Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid / J __
l./f' IJ I
Date 1/_ Iq-..3
Recem()t,~
IB~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245