HomeMy WebLinkAboutMechanical 99-1193
CITY OF PRIOR LAKE
IN~ECTlc>>I NOTICE
SCHEDULED
ADDRESS 43q I
~jltrht.
Sr
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL m
o SITE INSPECTION~
COMMENTS:
fuA~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o JLUMBING FINAL
JYMECH FINAL
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DATE TIME
I~ 'i:Jo
Cf'i-J/91
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR 1ST
o
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~KJ CALL FOR REINSPECTION BEFORE COVERING
Inspector: f:1:1. ( Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
ADDR ESS !.l -S 9' /
OCCUPANT
HEAT LOSS
SOLD BY
Electrical Work By
TYPE OF HEA T GA
9f- II rG
L)~\
HOUSE H EA TING TEST RECORD
b
APT. FLOOR CITY f t..,L-SUBURB
. OWNER I~'" n:> /;lS .R J4 finA Tz
DATE HTG. INST.
.FA Y HW
MAKE I? l.J t.J ')GAS'DESIGN
Model U ~ P 1-1 !-. .
Serial FD .>1)3 ~ ~A U f; P
INPUT --.C ?s-g~I=.'l 199 ~~ -.,?
.~ CONTROLS
THERMOSTAT .l-.F '/;== Heat Plug
Valve ~/__ _~_~
.,.
Limit s"/VAP n) j'~
Limit Setting I ') 0
Fan Setting r~_ ~ Ii?
PilotType L)...~.~~
Pilot Make _, ,
Pilot Model \.
Pilot Timing (
L. W. Cut Off (
Pressure 'S ,S ~e
Input CFH -'=' "/...s a 0
Stack Temp. ~ Cj >L/
Form 235
Percent CO ~ I' 3
Percent 02 C7. C
. Percent CO'" ()
STEAM
INSTALLED BY
. Gas Line By
SPACE HTR.
OTHER
..
UNIT HTR.
CONVERSION
.MAKE OF BURNER
Model
Max. BTU Rating
. MAKE OF FURNACE
Model
Vent Size
t...; /,;.?
KIND OF LINER _ SIZF NONF
Draft Hood Regula,or ~LJ(VPh~ S. VS}-.ePn
. Filters Size J(.y2.C:Y LNumber ~ 'L-- -
Chimney Location Insid~' . X- Outside
Chimney Construction hJ -e.. "JI'Q L S .....
Smoke Bomb
Draft
. Door Pressure
Wiring
.Test Tag
Lighting Inst.
/ tJ - 7- 9 9-
_I: ~iI(.}..s m.l /': //A.JV,,5~ L
\.L.o.-u
Date Tested
Company Testing
Name of Tester
CITY OF PRIOR LAKE Me
16200 Eagle Creek.Av. S.E. Permit No. t7t:!.../ /q3
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
Date q. Lt" qq PID# 25-008- 0/4-0
Site Address 4391 DAKOTA ST SE 1<.1
fer-
Owner's Name
Addition PIC?-/O~ /te.-1e6.s
THOMAS RAGATZ
DAKOTA ST SE
Lot Block
Address. 4391
Heating Contractor
RON'S MECHANICAL, INC.
12010 OLD BRICK YARD RD
Address
Telephone # 44 5 - 8 5 8 5
Furnace Make & Model "'R. LtLlD
Model Size 1..1 ~"? .\4 D Cot::: 'A-l). ~
Conn. Load
Fuel
~G
Flue Size
Supply Openings
Return Openings
Input (Q-:+: C:WOutput 51\-:, DW
Edr.
Cfm.
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Other Devices
Alterations
Replacement
TYPE OF WORK
New Construction
Repair
. Est. Comp. Date
\500
Building Permit #
5Q.5)
Est. Cost $ .
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
\.U).W
1.
1f).5.<1q
t?Q-//t?.,3
Receipt #
3C:,Z 75
TYPE OF STRUCTURE.
1. Pink
2. Green
3. Yellow
File
City
Contractor
Single Family
Commercial
~
Multi-Family
Other
Two-Family
Industrial.
Public
Fee Schedule
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
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 buildinq permit number before build-
ing certificate of occupancy will be issued.
HEAr 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
case of all work which requires review and approval of plans.
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Date.
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