HomeMy WebLinkAboutMechanical 03-0993
-. rv OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
I(()~~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED
[r1-()
/,,/),,; ,
CONTR.
PERMIT NO.
'1-qq'J
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MEcH FINAL
'f(//"'-'/A' / h-
I
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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o WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORREC~ :~R>>ALL FOR REINSPECTION BEFORE COVERING
Inspector: 1.f..r" ~- J...a'-~ner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
UUNO"
BVftN~ ,yILLE
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave S, Savage, MN 55378 . 952-894-0005
Orslat Test Report for Jobl 5y.3 c 6'
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Occupant t ('. ,I (r",,: t r 'i Sc.....
Date of Inslall "/ - ,) ::::.' ow..../
Type Of~. F/A / ,HW "
Other ,\ . '1'"'\ ,(A I-C ( {<.::.
Address
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Space HT
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UnitHT
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Make
Model
Serial
Input
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Pilot Type HOT SURFACE IGNITOR
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Pressure .,;; . "/
Input CFH .:;',) (" ,'">
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SlaCk Temp ?...b
Date Tested
Company
Technician
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02
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pr
7 J 3 - 03
B NSVILLE HEATING & AIR CONDITIONING
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CITY OF PRIOR LAKE
HEATIr -.. -- --_~___~M~m~ ~n"EPLACE PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 8/03 .
Date Rec'd
1. Pink
2. Green
3. Yellow
~:~ I PERMIT NO. () 3-t.,a~
Applicant -, -It\-)
(!'lease ~ or 1>rint and sion at bottom)
I ADDj{;& 5Tt LL{oil sAve,
Ss
ZONING (office use)
~
LEGAL DESCRIPTION (office use only)
LOT q BLOCK I ADDITION
OWNER
(Name)
P#w ~rY-
VOvUJ Chy)-~~
~
PIDI15-0/1- Od+-()
Q5J-(/tf7-l/W
(phone)
(Address)
APPLICANT
(Name'
(Phone)
~ .. & \',... I....~
BurnsVllle nlOaulI'd . -"1...--
12481 Rhode Island Ave. ~o.
Savage, M!ll~~" (City) (Zip Code)
(Contact Person) ,\\.JJJ..'"L - 14 ~ n-: (Phone) Cf,S'J...-: &94-000 5"
/' -APPLICANT SIGNA~URE AM. U . CJ~~- DATE I!;:)..;;;;t I 0 3
\.6.PLICANT PLE~~E COMPLETE BELOW
DNEW CONSTRUCTION ~REPLAGEMENT D ~L TERA TIONS , I
FURNACE MAKE AND MODEL lRlflf'rfTI. (" u 0 u trV 0 90 - 0., 0 FUEL 'jJtJ7\, qa.5 ~
FLUE SIZE RETURN OPENINGS INPUT to: 0 OV OUTPUT ~
TYPE OF SYSTEM HEATING OR POWER PLANT
OWann Air Plants I n All ^ .-<V 0 Steam
OGravity L--t/I\Y VU ,.. 0 Hot Water
[d Mechanical I L 0 Radiation
~r Conditioning \ ," l\ CJ--.O ^ 1 0 Special Devices
OVen!. System V 0 Other Devices
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(Address1,
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial. Commercial & Multi-Family 1 % of job cost
$39.50 minimum
Residential, Heating & AlC (New Construction) $99.50
Residential, Heating Only (New Construction) $64.50
Estimated Cost $ S.I (jf) I ao
. I
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Residential, Gas Fireplace
$39.50
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Building Permit #
$
$
$
~,so
.50
LfU. nu
fiee Use Only)
Building Official
I Paid t.)6....
I Date r
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
. Re't!QlJ7<l
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This Application Becomes Your Building Permit When Approved