HomeMy WebLinkAboutMechanical 00-0964
DATE TIME
CIT" ,)F PlilOR LAKE
INSPECTION NOTICE
SC~I;DULED
/2//'1 loa
/ /.' eM
ADDRESS
LlLlI/
:J)A e:.a fA
OWNER
CONTR.
PHONE N' ).
PERMIT NO.
o - '1t.n l/
o FOOTII G
o FOUND \TION
o FRAMII G
o INsUUl nON
o FINAL
o SITE IN lPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
t1\\ 0 PLUMBING FINAL
I.!:V ~ MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMME NTS:
l~
(~
J WOR~ SATISFACTORY, PROCEED
I ~ CORR oCT ACTION AND PROCEED
o CORR/:CT WORK, CALL FOR REINsPECTlON BEFORE COVERING
Inspecto1: ~. \ Owner/Contr:
CA~L 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CO~E REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
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GAS DESIGN
MAKF
Mod.1
s.riol
INPUT
r A'eV:>../ lK'--
rH.Tu.ACM"11 - / t..J
'-J)~()A-!:}<)'L
1=1.0..0001
THERMOSTAT 9'500 CONTROLS
Heat Plug
Valve
limit
limit Setting
Fan Setting
Pilot Type
Pilot Make
Pilot Mod.1
Pilot Timln.'
L.W, Cut Off
Pre.sur. ~ <
Input CFH eQ. c,o 0
Stack Temp. 7'"77
Form 235
~IXV'.-'
L
,--\0--)
,
^/rt
~ _ ,(2-1 ~r ,-
7~
--;>,
Percent CO2
Percent O2
Percent CO
~I
HOUSE H EA TlNG TEST RECORD
R.C,
-, ('-
/)
APT. _FLOOR
OWN..!'}'
CITY p,/---. SUBURB
~"-"<
^" "c.rIA 1-1,. A {
CONVERSION
MAKE OF BURNEP
Mod.1
Mox. BTU Rating
MAKE OF FURNACF
Model
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ADDRESS 'PIII [)AJ<:CTA
OCCUP""T I.-'P,J..J"A LI-' '---' j LL
HEATL.OSS--OATE HTG, INsT."'J;7~.~]" Co
r ,
SOLD BY /V! I NN>'7:,I><<,.O INSTALLED BY
Electrical Work By '~Ar ,.r v->AY Ga. Line By
TYPE OF HEAT GA_FA-LHW_STEAM_SPACE HTR. _UNITHTR. _OTHER
Vent Size
4"
KIND OF LINER r.' AL,~ t1 SIZE
<"
Draft Hood Regularor
Filters Size I LI~ 2:. C Number
o,lmney Location Insid. X Outside
o,imney Construction _ ( LAoS/;. ~
Smoke Bomb
Draft
Door Pres sur.
Wiring
Tu. Tog
lighting Ins'.
" /"
^
"/2-I/cC'
r I2c io- J /I? CC-J-IA A-I C/4 L
~~_7 '.>'r~c..fff'jLS
Oat. T..ted
Company Testing
No,... of Test.r
NONF
IV
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CITY OF PRIOR LAKE Me
16200 Eagle Greek Av, S,E. Permit No
Prior Lake, MN 55372
Date
HEATING APPLICATION I PERMIT
\D~n.o0 PID# ;;}5'-()()fi-Ol~-O
sae Address 44 1 1
Lot -Si- Block <>
DAKO'l'A "'I'
Addaion Pr,'or Itr rEf;
Is+-
Owne(sName WIIT.T.IICF. WILL
952/447-2356
Address
4411 DAKOTA ST
Heating Contractor RON'S MF.CHIINTCAL, TNC_
Address. 12010 OLD BRICK YARD RD
Telephone# 95'</....='-050:>
Furnace Make & Model (' .~ l2.. \ ~
Model Size S'i<.I\A.ADSSO
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanicai
Air Condaioning
Vent. System.
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Conn. Load
Fuel
NGI
Flue Size
Supply Openings
Return Openings
Input <boDeD Output lo~.OOD
Edr.
Other Devices
Clm.
TYPE OF WORK
Aaerations
'{.
New Construction
\ \-";}'d.D()
Replacement
Repair
Est. Comp. Date
\C)Db
Est. Cost $
Building Perma #
~. <::D
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
,50
4o.cD Receipt# 3~ 10 47
TYPE OF STRUCTURE
1, Pink
2. Green
3. Yellow
File
City
Contractor
Single Family. "f-.
_ Two-Family
Industrial
Public
Multi-Family
Other
Commercial
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential. AC Only
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39;$6; DCT J j 2000
$3(lJ~1
Remember to add the Stale SurcharQe on the botto... ...: .:;.,:,:. ",....p::~c.~:,g....
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections will be billed at $35.00 each.
House Heating Test Record must be submitted with buildino Dermit number before build-
ing certificate of occupancy will be issued.
HEAT QALr.1J1 AIIONS .REQUIRED wah number of supply and return openings listed per
room with CFM's per opening. New structures or additions send floor plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are B a.m. - 4:30 p.m. ,.,
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-9850
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
~~Qe)f~
A0 ca~ Signature
/~
Build~\l Offical's Signature
119 -~-o0
Date
/f-/~OO
Date