HomeMy WebLinkAboutMechanical 99-566
ADDRESS
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DATE TIME
SCHEDULED 9-007J-O -1 lIS-
/!-/9h Javel frlJe-
, "TR.
CITY OF ~RIOR LAKE
INSPECTION NOT.JCE
OWNER
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION @) 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
NINAL 0 PLUMBING FINAL
/ 0 SITE INSPECTION 0 MECH FINAL
COMMENTS: Fuy~ace FtJ L.
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o CORRECT A_AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
13{P~ -fZfZ
HOUSE HEATING TEST RECORD
AOOR"'. fSfp':Jf.:: 1If!y.~ .1::: ;41.1,/, APT. FLOOR
OCCUPANT LilIA ^ r OWNER
HEAT LOSS ,.. 9A_TE,HT~. INST.&)-:;1.1 -tf?
SOLD BY ~"N ~- INSTALLED BY
Elec~icol Work By l'-6faJ Go. line B,
TYPE OF HEAT GA FA ~HW STEAM ___SPACE HTR.
GAS DESIGN
MAKE
MocIel
Serial
INPUT
L~
l23 '3 a.Q. ~ ~-".J.
t;f99E I 'l'7L S- -
,~."D() ~J.
_ c -
CONTROLS
THERMOSTAT tl'1P ~,ot PI.ft-
Valve -----fA.N.. 3f..€,-S't - g/01l
Limit ~<_~
Limit Se"ing }.!tJ!OP
Fan Setting +~ ~/lJ)~)e<_
Pilot Type - JJS]:;.
Pilot Moke .:, J I c.v ~
Pilot Model _~ ~
Pilot Timing JO~a-.
L.W. Cut Off -
Pressur. ,3/s:t(VV~~&,~ CO2 r
Input CFH 7"-' Percent O2 "7
___ :i..
Stock T .mp.. Percent CO IJ
MAKE OF BURNER
Model
__ Mo.. BTU Rot'",
MAKE OF FURNACE
Mode'
@- 5(P(P)
ClTYJ~~ ..:./
I
C,,~
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L'-
lot
UNIT HTR.
OTHER
CONVERSION
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V
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/ \
, \
:), (.( 1(/<:-
KIND OF lINER_ ,4' \(.iV'A" SIZEY" NONF
Draft Hood __~ Regullltor ~-3
F i Ite.. Siae _ t;.A-t'" Number I
o.l",,..y location In.lde ~ ..,Qutaide
o.im_, Con.truction ~
Wirin,
Teat TII'
Lithtln. In.t.
S-d.-I-liQ ~
C J.r.e,.,' N'- .
1M
c:::::::A,... c:....
/'
Vent SIze
Smoke Bomb
0.. aft
0- Pr...ure
---
~
Dot. Tuted
Compan, T e.ting
No_ o' Te.ter
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CITY OF PRIOR LAKE
16200 Eagle Creek Av. S.E. Permit No. 9C/ -!5bb
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
Date 5~13-tjq PID#c75-143 - oz4-c;
Site Address J a;;;2/0 H- 'j,}, h ~,Ate-. A l/v Je../ ~ D 0
Lot 5" Block z.. Addition ISLAND 1//5W /q- /lDON..
Owner's Name J-...'jY1 Y1 g 11 r F ref?..
Arldr~ 15lo:llo ?;:'~--..t~ P("I~V" k:I~)U"... ~ ~
Heating Contractor , I cA. J rr:; ~Y7 ,,--. .
IvJdress7!J:?,;lU.b4h, 7~A tIP,", ~evzlh;lJr"" ~'>~
v I ,
Telephone # 6J? -91ft -/CJl./.
Furnace Make & Model~x l:r~d1&3-75"' TYPE OF SYSTEM /'
,e:::- Warm Air Plants !./
Model Size ;/:::> -~ Gravity
Mechanical
Air Conditioning
Vent. System
Conn. Load ..e:;--;;?::;:20?-
Fue~ Flue Size ~L-
Supply Openings
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Return Openings
Input 7~ Output 7r~
Edr.
Cfm.
Other Devices
Alterations
TYPE OF WORK
Replacement l7--- New Construction .
. Est. Comp. Date <,"-;;z.~-77
Repair
Est. Cost $ ?& ~t?.. a::::> Building Permit # q" - 5~ (p
HEATING PERMIT FEE $ ~ t.J t ~O
STATE SURCHARGE $ .50
TOTAL PERMIT FEES $-.&.5: aD Receipt # 3 s 200
~ '3 ~ ~-rJ-P\f(
.&.t.&~ TYPE OF STRUCTURE
..., I 8 1999 .
Single Family /" Two-Family
L Pink
2. Green
3. Yellow
File
City
Contractor
Multi-Family
Commercial
Industrial
Public
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 m. inij7u
$99.50 !
$64.50 rjA.. .('j~t. . '
$39.50 I"~
$39.50 v~.
$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 numb~r before build-
ing certificate of occupancy will be issued,
HEAT .QALQULATION~ REOUIRF;Q 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 of all work which rlquires/eview and approval of plans.
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Date'
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.Permit# cr q -- S'fc,p
.Job Address /filo?lJ;~, AJtJi.-.
.He~lingContr&ct~ .P~, I J.1f>o_,~1
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.Testel1l/Signature /' or _ __, ,
Date
Pounds
Pressure
Time
.Gas Une
Pressurized
Inspected
PERFORMANCE TEST
.Percent CO2 ~ .Percent CO (")
-
.Percent 02 I .Stack Temp,
Final Inspection Date
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