HomeMy WebLinkAboutMechanical 99-0802
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
SLfJ 0 /1I1Md/ fU
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RJ
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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COMMENTS:
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DATE TIME
t.J-7
~ - g-z;I"2
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
jA WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREC~R ALL FOR REINSPECTION BEFORE COVERING
. 7~
Inspector: ~ -); rI) Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANC~
uaNOn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
HOUSE HEATING TEST RECORD
ADDRESS ~"3cJ ~rk 'GJ Sf; PT._FLDDR CITY ~L SUBURB
OCCUPANT. \<v....\..-..-'" L\-AJ~~ ^WNER. 5~..
HEA T LOSS DA TE HTG. INST. .
SOLD BY M: ^"""c.<,~ r JSTALLED BY _ 'Q ,,"'oS At.... he.nt... 1
" V .1. I . . .
ElectricalWorlr:By. rl"')~Jt'~~~ it.:..'""~i.",', ....., Line By.
TYPE OF HEAT GA_FA""" HW_STEAM_SPACEHTR._UNITHTR._OTHER
GAS DESIGN
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<;-"Xl:\L-A- 1l{J - 1-\ ~
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MAKE
Mod.l.
Swial
INPUT.
THERMOSTAT
,Vah,1
Limit.
Limit Setting.
Fan 5.ttin'
Pilot Type
Pilot" .
Pilot M.. I
CONVERSION
~
Max. BTU Rating . ~
, "E OF FURNACE ./
Mod.1 (
AKE OF BURNER
"',1
CONTROLS
Heat Plug
V.nt Siz,
t,1I
~
..-k
.~, \rUl/ A
'1/" r--.____ /
\~ ./"'./
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~
KIND OF LINER _ SIZE IA t"I
Draft Hood _ Regulator
FI It... SI,. ,,,. ~S - I . 'umb. .'
o,imney Location Inside, .............. Outside
Chimney Construction L I It; ...r
NONF
Pilot Timing
L.W. Cut Oil
3 /I
Pressure ~40) we
Smoke Bomb
Draft .
Door Pressure
--.- Wiring _
'/ Test Tag
./'" Lighting Inst. _
"-
Ie> -1"'7-n..3
P"...'\ /1Al'rh"'''''/L...
~
Input CFH_
~tack Temp.
FOI'm 235
Percent CO2
P.rcent O2
Percent CO
17./
'1.7
r')
Dot. Tested _
Compony Tuting
Name of Tester
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CITY 6F PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
i:;';;,':, ~::y IPERMIT NO'03- C;A~
3_ Yellow Applicant I " t:/C./ \-
ZONING (office use)
Jel S 1)
,~J11rJ/YltJZ/d.rs:J PID~5-070'-m1J7'0
(Please type or print and si2l1 at bottom)
ADDRESS
543Cll MANOR RD SE
LEGAL DESCRIPTION (ollice use only)
LOT ~ BLOCK d- ADDITION
OWNER
(Name)
BARBARA DAVT~
(Phone) Q<;?_L1L1"1_147f'
(Address)
5438 MANOR Rn ~F.
APPLICANT
(Name) RON'S MECHANICAL, INC.
(Phone) 952-445-8585
(Address)
12010 OLD BRICK vn ~n
(Address)
~HAKOPF.F.
(City)
'i'i3?9
(Zip Code)
(Contact Person) \. , (Phone)
..APPLlCANT SIGNATURE (*'\ wJiI \e)/~ . DAT~
APPLlCAN~PLEASE COMPLETE BELOW
DNEW CONSTRUCTION, 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL ~'( Y\.2..Y' 5'5D LA \\ V FUEL
FLUE SIZE RETURN OPENINGS INPUT ./In.ooc) OUTPUT 9$,()(Jt)
TYPE OF SYSTEM
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3q.g)
.. _,50
l.ff} .11U
lice Use Only)
This Application Becomes Your Building Permit When Approved
r Paid $ Lj 0.-----
I Date t;2 - !?f> '3
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 4474245
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39,50
$39.50
Recei'1?q~c-
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