HomeMy WebLinkAboutMechanical 03-0903
DATE TIME
CITY OF PRIOR LAKE ?- Jo
INSPECTION NOTICE SCHEDULED
ADDRESS 111 (( L ~tAy VrfA.4.
,
OWNER CONTR.
PHONE NO. PERMIT NO. (- C(O:J
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: r::cN~~l< /4 c
/ '
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1./1 / (J /
1 \"'/,
[l' WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECffWORK A LL FOR REINSPECTION BEFORE COVERING
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Inspector: 1",,'0 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNon
--..._....~"-,~.._.,--'.-.._._-~.__.,._<-_.,.,_.....,...----
HOUSE HE~TI~~ST RECORD
ADDRESS /4 .I );;t.. B tl\. V t,.; '.e:Lt) G {' .PT. FLOOR CITY SUBURB P. I
OCCUPANT. J:Se.\..,...-\I\.... ReJ.. oJ\d)~ . .......;20WNER
HEAT LOSS DATEHTG.Jti$T. _ 7,(J'1/L/,",- ,t:} \
SOLD BY, /?? r In tAPC\ ~~':::l L ~ -INSTALLED BY. P\D ~_ 'C
Electrical Worle By ~ r.o., Line By _ .../
TYPE OF HEAT GA - FA ~ HW STEAM SPACE HTR. UNIT HTR. OTHER.
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s: D :::~ ~::::;re - '7// Y/OZhljng In. I. -
~::c1- Company Testing. ko ~M
f yr- Name of Tester. ''7 c- ~
MAKE
Moclel ,
Serial
INPUT.
(. t ('-\ G~ESIGN
~- - -- & ..
D ~-.,... ... \.- \..-1
J qL:) ~ H .5 1,-- ~)_
;;?e5~~CJ
/-
; __-CeNTROL S
THERMOSTAT~qOt:-/.. Heal Plug r---.
Va In .l.- __ (,
Limit 1 _. ":.F-fl--.)....J
Limit Setting _ 1- \ 'fo... ( ~_
( I.~ .
Fan Setting ('\~
Pilot Type +\ ..:::, ~ _
Pilol Malee ...,.. /\J ~ 4.,f:::...J~
Pilol Model _ ~ '\"
Pilot Timing _
L.W. Cut Off ' _
Pre..ure - '?:.1~~ercent CO2
Input CFH ~-7 ,- Percent 0
Stacie Temp. - /7>> Percent C02
Form 235
MAKE OF BURNER.
Madel
Max. BTU Rating _
'''AKE OF FURNACE
CONVERSION
~~.
./ '-
Model _
..,
Vent Size
6
I'
KIND OF LINER
Draft Hood
Fi I'er. Size
Chimney Localion
Chimney ConSlruction
SIZE
Regulator _
Numb.r
NONE
y~eQ~~ -+Uhiz'''-.e ,_ _
Smolee Bomb
Draft
Wiring.
T.., Tag
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Dite Ree'd
~. ~e~n ~~~, I PERMIT NO. /I 3 _q' h V,
3. Yellow Apphcant ( J V r
(Please type or print and si2l1 at bottom)
ADDRESS ZONING (office use)
14112 BAYVIEW CIR NE
LEGAL DESCRIPTION (office use only)
LOT Lj BLOCK ;;;L ADDITION
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OWNER
(Name) KEITH & DEBORMLIV~ limA
(Address) 14112 BAYVIEW CIR NE
APPLICANT
(Name) RON'S MECHANICAL. INC.
PID 25- / ()-3 - 00 g - J
(Phone) 952-445-9618
(Address)
(Phone) -9..5.? -44 5 - 8 5 8 5
12010 m,n 'R1HC.K vn 'Rn
(Address)
-l~
APPLICANT SIGNATURE ~~ ~ '('(J.JI.{J.;.y DATE
APPLICA~ PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL 1o.K'r u, ( n~ ~ ofiJ "' FUEL
FLUE SIZE RETURN OPENINGS - INPUT <QD,()(JV OUTPUT ~ tcOD
,
<::HAKOPEl<'
(City)
(Contact Person)
(Phone)
TYPE OF SYSTEM
DWarm Air Plants
o Gravity
~ ~pchanical
{; ~ Conditioning
JVent. System
HEATINGORPO~RPLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $ ~O
Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
~.q)
r _.50
~h).OU
lice Use Only)
This Application Becomes Your Building Permit When Approved
Paid~ tJ . ...,.,.
Date 7- <j-- :3
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
l'
Ml\T
C;C;~7a
-(Zip Code)
-==1.~- ~
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Receipt Nt; Lfgl.f?
By ~
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