HomeMy WebLinkAboutMechanical 99-1264
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~-cJJ-OO
ADDRESS
15:3;) S E~ 4A
,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
CJ9-lolti
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
~MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
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X WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
ADDRESS /C?d~ ~.LL Ll/bA
OCCUPANT -rut;./'I . f'pC::A-_
HEAT LOSS nATE HTG. INST.
SOLD BY m~ L- .
Electrical Work By //4. r'-/'..;-... E/:~
TYPE OF HEAT GA FA~W
HOUSE HEATING TEST RECORD
/Ir /Je
99 -/2-frp4-
APT.
.OWNER
FLOOR
CITY
SUBURB
fJ/ ItlTla ~L-
STEAM
.INSTALLED BY
.Gas Line By
SPACE HTR.
~~~~
UNIT HTR.
OTHER
~ /'. -1 ....G .AS DESIGN
MAKE...J /h\;......~r
Model I1r/.v1' ~'o r;FAI
Stria I ,t... <1-?.;J/ 5:-7/97
INPUT Lpd-dYC/d
,
.MAKE OF BURNER_
. Model
. Mox. BTU Rating
. MAKE OF FURNACE
Model
ct~~~ ~.~ ~'. \
.')) _.~--'-"
l\\ .... -
~ .... li.S1l
I I
"
J
~
THERMO,$TAT ~J'VCONTROLS
Valve /l-l~./ Heat Plug
Limit ,/Lu../
Limit Setting ~/! ~ -
Fan Setting ~"' /,,,
Pilot Type .JI~~.J.<
Pilot Moke _..4!-L./
Pilot Model - ..
Pilot Timing /- J,~
L.W. Cut Off
--
-4
Vent Size
t;/'
KIND OF L1NEP
SIZE
NONF tr
Draft Hood Regulator
Filters Sizejtr.},)'u( Number I
Q'limney Location In'-te, f
Chimney Construction -/,{ .I--
Outside
. Door Pressure
Wiring U
" iT
,Test Tag 'I
Lighting Inst. t)(,
. Smoke B09Jb /
. Draft YP:~
Pressure ~ .(-
Input CFH /.?I~
Stack Temp. <'7/r'
Form 235 .
Percent CO 7
2
Percent 0.2::,,(
Percent C02 d
Date Tested /t/~,;7)- f1' ."'-
Company Testing ~~/7i ~ML~
Name of Tester ~jV/ ~#
CITY OF PRIOR.LAKE
16200 Eagle ~reek Av. S.E. Permit No. qq-/zr04--
Prior Lake, MN 55372 .
HEATING APPLICATION I PERMIT
Date-10- 1.5-'?'1 PID# 25- 07/- 007-0
Site Address I ~':5f2~ ~ 8...J Pi I ~~ 41 It fJ.15 . Iff!..IS.O
Lot (, Block I Addition N~/2..77 II/S'o NoS / St-. 2 #0
Owner's Name 'J(;fh.J p(.'!trt!-I<~
Address IS3~""- E?bc. ~wM'€1f: (!.IR... N.r$-
Heating Contractor Sv fJ ~ I () e ('..G..ur.('~.es I )..J ~
Address ~ 1'-, if:;;'"..,J;? A-v ~ ,u-o . ux. is'{1:rL, 8,.)
Telephone # &(~--cS-31-N1 (
Furnace Make & Model T6?H ~..sr~
ModelSize fJrc..tJ,IOD IO~OCD
-6 -:sV:l2-
Conn. Load
TYPE OF SYSTEM
Warm Air Plants )(
Gravity f
Mechanical
Air Conditioning
Vent. System
Fuel NN'r
Flue Size
Supply Openings ,
HEAnNG OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Return Openings
Input Output
Edr.
Cfm.
Other Devices
Alterations
TYPE OF WORK
Replacement, Y New Construction
/.
Est. Comp. Date /1-15-C(Q
Building Permit # _ 99-/ z(p4-
Repair
Est. Cost $
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
39.Sb
.50
'-If) . () 0 Receipt #
.36::>44-b
1. Pink
2. Green
3. Yellow
File
City
Contractor
TYPE OF STRUCTURE
Single Family
Commercial.
x
,
Two-Family .
Industrial
Public
Multi-Family
Other
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 Oel' 9.
$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 building Dermit 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
447-4230
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 ~ w~ which requires reVi.ew and approval of plans.
~~ I JIJ-IS4Cj
v /;~Applicant's Signl!luf~'/ ~.~ ,. Date
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JY/V,/V,,'_' t 't+.~'I7"'~ /0 ZO qq
Building Offical's Signature . Dite