HomeMy WebLinkAboutMechanical 99-1054
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
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SCHEDULED. '
ADDRESS
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/t.I/37 SA-V !/f(5vJ Clle..
OWNER
CONTR.
PHONE NO.
PERMIT NO.
1t:t . 1054-
COMMENTS:
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL ~. GASLINE AIR TST
o MECH FINAL \~' FUR/\! /t(!.,6
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
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'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: m I Owner/Contr:
J
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
MAKE
Model
Serial
INPUT
THERMOSTAT
Valve
Limit
Limit Setting
Fan Setting
Pilot Type
Pilot Make _
Pilot Model
Pilot Timing
L. W. Cut Off
r;.~")
Pressure
Input CFH
Stock Temp.
Form 235
"3 X"
Joe Ml'JO
3 ',f{o
crq- /()SLf
HOUSE H EATING TEST RECORD
CONTROLS
Heat Plug
\-\>ctO
./
.ee::..--
APT.
OWNER
INSTALLED BY
Gas Line By
SPACE HTR.
MAKE OF BURNER
Madel
. Max. BTU Rating
. MAKE OF FURNACE
Model
Vent Size
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ADDR ESS / '"!J J 7 ~G \I '" I~ r..,
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OCCUPANT K:~! 5<.~:~ Pl/V~
HEAT LOSS DATE HTG. INST. 9- h -9"
SOLD BY /V1j~c::'~/7
E lectrieal Work By R . f'7,r """-"~ t/
TYPE OF HEA T GA FA.k Hy( STEAM -
GAS DESIGN
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AI-r"rl.'O{) f'_CA
L <1 'i \ 0 \ f( OS' ~
It> <> 0""""
,
KIND OF LINER
Draft Hood
Fi Iters
Size 1(,)( 7..0
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.)> V ~'.. '{' . \ \..\...
Chimney Location
Chimney Construction
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/1'0\
)7
.Percent CO2
Percent O2
Percent CO
Smoke Bomb
Draft
Door Pressure
FLOOR
CITY P. L. SUBURB
Rol'\'~
M......" "-< '^: ~"" I
.
UNIT HTR.
OTHER
CONVERSION
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X
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,
SIZJ:
RegulaTor
Number
NONF
Inside
l. "
Outside
A- ue^,"
V
/\
Wiring
Test Tag
Lighting Inst.
V
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"1 ,q 7~ Date Tested ~- ~,., - 'tCi'
ir.4 9a.. Company Testing _RONIs ~~r~^;"'~\
O'n Name of Tester <:;,,",,'H c&.c;+-e/ .
CITY OF PRIOR LAKE MC
16200 Eagle Creek Ai. S.E. Permit No. q;t::l ~/()5"4-
Prior Lake, MN 55372
TYPE OF STRUCTURE
L Pink
2. Green
3. Yellow
File
City
Contractor
Single Family
Commercial
~
Multi-Family
Other
Two-Family
Industrial
Date
HEATING APPLICATION I PERMIT
%'~3.qct PID# 25-/28.... 003~()
14137 BAYVIEW CIRCLE }e/~L)
Site Address
Lot 3
Public
Fee Schedule
Block -1 Addition '84 VV I € W A DDN .
KEN SCHERPING
Owner's Name
Address
Heating Contractor
Address
14137 BAYVIEW CIRCLE
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
12010
RON'S MECHANICAL, INC.
OLD BRICK YARD RD
SHAKOPEE, MN 55379
Telephone # 44 5 - 8 5 58
Furnace Make & Model lempstay
Model Size N rc/..Q 100
Conn. Load
Fuel
vb
Flue Size
Supply Openings
Return Openings
Input tOO. ODD Output <60, ODD
Edr.
Cfm.
Alterations
Repair
Remember to add the State Surcharge on the bottom of this application.
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning ;)--te-n
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
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
Other Devices
TYPE OF WORK
Replacement Y.. New Construction
Est. Cost $ I),fJDO.oO
Est. Comp. Date
q/qq
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 which requires review and approval of plans.
99-1054-
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
Building Permit #
\~Q,5D
.50
4D.cV
g. ?3.QQ
Date
6/2..er/9~
Date
Receipt #
3(0021
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Building Offical's Signature