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HomeMy WebLinkAboutMechanical 03-1238 DATE TIME .<IOR LAKE '{-1M .,mON NOTICE SCHEDULED AODRESS S.J' q !- P/A4I./ OWNER CONTR. PHONE NO. PERMIT NO. :7 --/1.- J. 8: o FOOTING o PLUMBING RI o EXIGRADIFILLING 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: ~/rY1t1C-f.. ----- /~Jl{r ( L..-- \ 'J;;"" .............. ~~ 1( I -r ( (~ / /" ------ ~K SATISFACTORY. PROCEED o CORRECT ACTION AND PROCEED o CORRECT WO~K.~L FOR REINSPECTION BEFORE COVERING Inspector: r VI. q. (~"'~r/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INS1IOTI HOUSE HEATING TEST RECORD ADDRESS 53&''1 LEMLEY C-Ji? -S.I5. OCCUPANT "'TI{o.-"1A~ 1>AY HEAT LOSS . DATE HTG. I'NST. "l-/S..""'s SOLD BY --;>Jlll-t:/vA/ ~~~. INSTALLED BY $~A/T'r.AL Electrical Work By ~rF--A/ I':>ftt:5Ll::::- Gas Line By It TYPE OF HEAT GA _FA ~HW _STEAM _SPACE HTR. _UNIT HTR. _OTHER MAKE Model Serial 12 \.AU I> GAS DESIGN U_G P:f-07EAv.EE. .' :r~7>~{)~~{j<,nl'::;<' / . 'J~ 4cO RTVt''] - .- / INPUT THERMOS~~ "'1'-/00 CONTROLS JPv...; Heat Plug '~ J91!T~r F1C, "F , .l;AAeJ!. '.flvJ Va Iv.-' Limit Limit Setting Fan Setting Pilot Type Pilot Make Pilot Model Pilot Timing I<JE<::.' L.W. Cut Off 5'{( Pressur..' <. W* C. Percent CO ,% -J<) 2 Input CFH ._ 0-&0. Percent 02~~ Stock Temp. ~D e r Percent CO Q Form 235 APT. _FLOOR _CITY OWNEP SUBURB CONVERSION MAKE OF BURNER Model Max. BTU Roting MAKE OF FURNACF Mod.1 I I II /.L I' {. Vont S;u J.+ CLA77 C KIND OF L1NERrL.,A-Y; ,. f<;," SIZE t,. Draft Hood RegulaTor Fi Iter. fA:<:- Siu 7..ex-zS~ J Number / Chimney Location Inside ~' A _ Chimney Construction / '"' (r-\ NONF Outside Smoke Bomb Draft Wiring Test Tog Lighting Inst. ""I-/c;-e93 P~~b/? A/"'7:J:3IIL. c.f.t~5 Door Pressure _ Date Tested Company Testing Name of Tester / CITY OF PRIOR LAKE HEATING/AIR CONDITIONINGIFIREPLACE PERMIT Date Rec'd ;;;;;,~" ~:~ I PERMITNO'o2--p~16 3. Yellow Applicant !:/ '-'I :ase tyPe or print and siJm at bottom) \ _ .DDRESS 5'36'1 lk,.....,L-E,--( ZONING (office use) e,a r, r_ s.~ LEGAL DESCRIPTION (ollice use Duly) LOT j BLOCK / ADDITION 1iP};2 ~If)~ PID,;25.... ()5S-r.JOI- 0 ~ I OWNER (Name) ~ Irl,'I""'r-\s '])<"1-'- (phone) qs z. 22f:.,-/,46{, (Address) ;:'"J, {.,q L (:, "^ I {-'-C L ,RC.LC- 0. (, APPLICANT ~ (Name) l' E:::..-S I~~--..-nf"lll.l \..I,{-....,...~.r ... A ,a, (Phone) bI7-7z..lf-tRQq l41 ~T 5,. ,e::", .-:-(- A Nl,~, ~,(-APClL.cS .i\>"l..... 6S'<<:ii~ (Address) '\ ~ (City) (Zip Code) (Contact Person) A.~ 00'" \:::.. \ (Phone) ^ (7.724 -IRe, C, APPLICANT SIGNATURE ~J--t( , _ DAlh I APPLICANT PLEASE COMPLETE BELOW DNEW CONSTRUCTION . REPLACEMENT D AL TERA TIONS rURNACE MAKE AND MODEL Juun U(::d]J'(,)7Ec~""'c'L. FUEL rJ"". FLUE SIZE RETURN OPENINGS INPUT .:i1l.DO() OUTPUT , HEATINGORPO~RPLANT I ~ 1"1 (:. (Address) G",'::;, 5f,. cn6 TYPE OF SYSTEM OWann Air Plants iGravity Mechanical Air Conditioning OVent System o Steam o Hot Water o Radiation o Special Devices o Other Devices PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks FIREPLACE MAKE AND MODEL Residential, Heating & Ale (New Construction) Residential, Heating Only (New Construction) FEE SCHEDULE 1 % of job cost Residential, Gas Fireplace $39.50 minimum $99.50 $64.50 $39.50 Industrial, Commercial & Multi-Family Residential, Additions & Alterations Residential. AC Only $39.50 $39.50 Estimated Cost $ -':L t, q ?> - 00 Building Permit # REA TING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ $ ?''i 50 .50 '-{(", . "0 (Office Use Ouly) This Application Becomes Your Building Permit When Approved Building Official Date I Paid L/O. --- I Date 9~/b ~.3 R~.r~57 Bo--.- v 24 hour notice for all Inspections (952) 447.9850, fax (952) 447-4245 16200 Eagle Creek Avenue, Prior Lake, MN 55372 1