HomeMy WebLinkAboutHtg Permit 02-0910
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
I.ZO.OC;
I
ADDRESS
5/53 1-/tJ,P6. sT.
OWNER
CONTR.
PHONE NO.
PERMIT NO,
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
o MECH FINAL
COMMENTS:
z. ~ q /0
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR T$T
o -1', tl ./
TI I"...;'
\
t!." t.- OS 6
DIJH . /Q
~"lFJ-6 PI 06'
j /V ~ e..:r/Vl TV
I
o 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.
_OTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
~.. /{7-'oa--2otJ
~/s3 ~ s..J- __ JJ.~AJty#f(
I '.~".~ (I /. I
. m'.... I
CONTR. ..,.d,,;;.. .' ....
PERMIT tt'~'::;~ - 7/ D c:/?
\ :.;- ~1.U)t..
o PLUMBING RI \. 0 EXlGRAD/FILLlN
o MECH RI . n r::n~cl ."
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
9 /lj/70 ;fk:;c 1f(fj
SCHEDULED
ADDRESS.
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
COMMENTS: hJ/t/J1tVL€
ArC., ~,
(IJ ~ L"\O__.*~ t:if A,~,
~.:ir; ~-~~ ~~
~ A-,G ~*.&:nc ~ ch
u~ ~ '_ ,JUl -h b-<- w
/ke.
/
t14d,d tu,P /)II~,''''~ ~ ~.'.""''' ,
U
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
"" CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ /l Owner/Contr:
CALL 447:8~ F~R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
HOUSE HEATING TEST RECORD
ADDRESS :5IJ3' Mg 5/. <if
OCCUPANT ,H-&/7L- ~/ /~
HEAT LOSS DA-h HTG INST 7-/-0-2
.5flR-f "-
A-Z
ItP T.
OWNER
FLOOR
CI TY ,fl.
_SUBURB_
TYPEOFHEAT
GA
FA ~HW
STEAM
_IHST ALLED BY
. ~, Lin. By
SPACE HTR.
\
~4~~-A~
,.
SOLD BY
EI.c'ricol Work By
UHIT HTR.
OTHER
MAKE.
Mod.'
J/' GAS DESIGN
/ r"'/)4J~/<"
'6/;?J-ro ~
020/bA7J'.a
9'c:? /?r- -
COHVERSIOH
MAKE OF BURHER.
Serio I
/.Iod.1
Mo.. BTU ROlinll
_ MAKE OF FURNACE
IHPUT
Mod.1 _
COHTROLS
THERMOS TAT
Heal Plug
V..nl Si... _
Volv..
KIND OF L1NER_
SIZE
NONF
Lirr.if
Limit Setling
Fan $.effing
Pilol Typ..
Pilar I.\ok. _
Pilar Mod.1
Drolr Hood
F; Iter ~
Sh..
Regulofor
Number
eh imney Location
Chimnfl y Con:J'ruct ion
In.id.. ,
Oul.id.
Pilot Timing
L. W_ CV. 011
Smok.. Bomb
Drorr
Wiring
T ..., Tall
'_ighlinq In.1.
Door Pressurt!
Pre'lsu,e
? . <}'"
Inpul C FH
Slock T ..mp_
Form 235
?i:;:O
P..rcen. CO2 &. "'-J
_ Perc..n' 0 ......
2-/-
_ Percen' CO 6
Dol.. T...,..d _
Company T",'ing
Nome of T""~H
jT-C? )--c::e
~~A':.7-d~/. At /- ~.;:;
"5'.:- ~/~
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
# <//jCtJ
Date Rec'd
1. Pink
2. Green
3. Yellow
~~~. I PERMIT NO./") ') - 4/0
Applicant vo< /
(Please type or print and sign at bottom)
ADDRESS
5/S~)
/ J,., /"\ 51' j'I' ,.--
rrWe ('-I. ( . t '
ZONING (office use)
~5D
LEGAL DESCRIPTION (office use only)
LOi)OBLOCK (~ ADDITION ~~ ;J~
OWNER
(Name)
fi'al) Ie DoLJM
(\PtJJlt acP (Pite
PIDo?S- /5'!J i)--1.;r()
(Phone)1Sa-Ljy-?~ 50/)/
(Address)
APPLICANT /t.--j" all L/) /J. rl' J II /oJ cf'\ 'r / /)
(Name) HUU (OJ/IV , n7 r, / '-U . (Phone) ; U a - Yv (r ./ /'7' 00
(Address) (i(~S /5~AfiJ eN we,?! (P~~/mA! '?z:~~~~r
(Contact Person) I )//hbi./}r-/J /1....--; (Phone)
APPLICANT SIGNATURE # /cI/1M/i.. / (li~) DATE 1/~~()d-
--- --- ------ -.. - -APPLICAN'f ~LEASE COMPLETE BELOW
ONEW CONSTRUCTION ~PLACEMENT 0 AL TERA TIONS
FURNACEMAKEANDMODELKeIlIY10r.e., C3nfJ/69 D FUEL l7al.
FLUE SIZE RETURN OPENINGS INPUT q 0, OfX.."':> OUTPUT tdi 6u<'L
TYPE OF SYSTEM
REA TING OR POWER PLANT
OWarm Air Plants 0 Steam
OGravity 0 Hot Water
o Mechanical 0 Radiation
~r Conditioning 0 Special Devices
A /0 OVent. System 0 Other Devices
~~:f\1AKEANOMODEI'R/"11l2L.y--~C{~Q,Q, _~L?: J-cy/l
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & AIC (New Construction) $99.50
Residential, Heating Only (New Construction) $64.50
Estimated Cost $ f)--{) ID ~
!
Industrial, Commercial & Multi-Family
$39.50
Residential, Additions & Alterations
Residential, AC Only
$39.50
~~
Building Pennit #
REA TING PERMIT FEE
STA TE SURCHARGE
TOTAL PERMIT FEE
$ c39. JO
$ .50
$ C/ (\. CO
(Ortice Use Only)
This Application Becomes Your Building Permit When Approved
Building Orlicial
Date
Paid / /,' c-JU
'-1' tJ /
Date
'/rd.'5~~
Rec~~5G I
By
~
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245