HomeMy WebLinkAboutMechanical 99-218
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
COMMENTS:
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JmORK SATlSFAqT'
o CORRECT ACTldN
o CORRECT WOR
SCHEDULED
DATE
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TIME
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CONTR.
PERMIT NO.
qCj- 2-l B
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLlNG
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
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Inspector: '--\ Owner/Contr:
CALL 447..4230 Fck THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQtjN18 ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~
.
. ADDRESS (t7 ~ IJ I
't- OCCUPANT
HEAT LOSS
SOLD BY 11.",,,,; $
Electrical Work By
TYPE OF HEAT
v "" ~.. f ~ ~y
DATE HTG. INST.
/"1' f J,.~ "': u. I
11; -/ H-1&.l
GA 'FA ~HW
,
A GAS DESIGN
MAKE /./,...., ~ -I,I:f....~
Model -6,) ~:DA (j c,("f]JO-) A
Serial S CLa./ t:f(J-r-, 1 ':Jet J
INPUT ~ OE.J -
THERMOSTAT -r")(/
Valve
Limit
Limit Sening'
Fan Setting
Pilot Type
Pilot Make
Pilot Model
Pilot Timing
L.W. Cut Off
Pre..ure -:l.~
Input CFH '-Ie; 000
Stock Temp. qJl.
Fit". 235 ..
I' \
rU'7
CONTROLS
Heat Plug
/I
f; .'t ~ JI
---
~ ^
>(.,. /1~ (<
.c::::.----
HOUSE HEATING TEST RECORD
,,~ ,- ti1
Percent CO2 i.lX
Percent 02-11J. OX
.. Percent CO ~J '/:
APT. FLOOR-
OWNER It ~v ...."...J
,
STEAM
INSTALLED BY
Gas Line By
SPACE HTR.
MAKE OF BURNER
Model
Max. BTU Rating
MAKE OF FURNACE
Model
Vent Size
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CITY 1J1.:?~ '
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UNIT HTR.
OTHER
CONVERSION
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X
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NONF
v
KIND OF LINER SIZE
Draft Hood RegulaTor
Fi Iters Size I {,'( -J ("{ "> Number J
Chimney LocaTion Inside)l Outside
Chimney Construction .).' PV c
V
Door Pressure /' \
Oate Tested ,,#. I ~ ,tj
Company Testing n .';$ ",..,'" ,r J..Q,.; c(; I
Name of Tester 6/( '9 J/( JJ.., .
/
Smoke Bomb
Draft
Wiring f ,
Test Tag V
Lighting Inst. /1
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CITY OF PRIOR LAKE
16200 Eagle Creek Av. S.E. Permit No. en - :1/'1
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
Date -.3- aLf.qq . PID # ~fJi?}-llfp-O( f - ('l
SiteAddress &SLi1 ~ ~*. ({t:b-
Lot Il/:l-[S' Block Addition v ~a.1M I Y7 ~~
Owner's Name RAYMOND CORNFORT~ 0 447-5318
.
Address 6541 KNEAF S EY S T
Heating Contract.?r
Address
RON'S MECHANICAL
SHAKO PEE
12010 OLD BRICK YARD ROAD
445-8585
Telephone #
Furnace Make & Model }rrMQ+'rCf'Y"C4
J
Model Size G I JQ1.A '-\ ~ 11")
Conn. Load
Fuel
tJ0
Flue Size
Supply Openings
Return Openings
Input _'-\5 ()OO Output Y. \ . ~SD
Edr.
Cfm.
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning -2 ~
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Other Devices
Alterations
TYPE OF WORK
Replacement '/-. New Construction
~
Est. Comp. Date '-\ - \. CV1
Repair
Est. Cost $
3cco. 00
Building Permit #
qq -JJ8'
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
3Cl.5D
.50
LfD. CfJ
Receipt #
j4~\~
LD..\I'\ nf'l)L
TYPE OF STRUCTURE.
1. Pink
2. Green
3. Yellow
File
City
Contractor
Single Family
Commercial
~
M ulti- f.amily
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.
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 of all work which requires review and approval. of plans.
.~~
.. Y-. ~lic
I \?lA......V;
Building Offical's Signature
~- ~tI~ 99
Date
.~-]5 41
Date
,