HomeMy WebLinkAboutMechanical 00-0831
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1082 Payne Ave.
St. Paul, MN 55101
651/772-2449
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. . GAS WORK ORDER
STANDARD
-~HEATINGO-
410 W. Lake St.
Minneapolis, MN 55408
612/824-2656
& AIR CONDITIONING
A Blue Dot: Service Co. EQUIPMENT INFORMATION
FIRST /AA ./ /(.., TYPE_
h<;'/u _ .diu//"\.. MAKE 1.17'<!4rvf
ZIP '57<- MODEL~3a ,AI)O 193 t?}lO/At'-tt<\
SERIAL '19 OD'" -; I Y-J p-
I NE-LR"" ?J ___ I'C-,v
,
q"-,A _r,-""
ORSA T TEST RECORD
C02 I_.-'? % METERED INPUT s<- 6 Ie"? ~ CHIMNEY TYPE B-v.t.., .f
( 0 (.,
02 ":;:p % LIMIT SETTING "2/rV FLUE SIZE in.
CO /J % PILOT OUTAGE U sec CONNECTOR SIZE ~ in.
-
NET STACK TEMP "7 C, / 0 TOTAL CHIMNEY INPUT J J /\ ,,0 '-' btuh
. --- /
,.,ci~ PRl~~ CITY OF PRIOR LAKE
~~ 18200 Eagle Creek Av. S.E. P::k No. () O. OS~ I
e Prior Lake, MN 55372
. ~1'AnNG APPUCAnON I PERMIT
Date .. vi GiV PID, Zt:;"-OM-/)[>PJ-O.
Ske Address ~ )...C I h.4r tf, U<:/ . Fee Schedule
-. , dJ.N
Lot -, Block L Addkion. .AI,~ ..s-~A!e; OI'JI<.S L{t':-ft Industrial, Commercial & Multi-Family
j'\~. J rtl ).. { h Residential, Heating & AC
Owne~sName ........' ~ b1, R 'd t'l H . 0 I
- 1lJ.. _ , . eSI enla, eatIng ny
Address 1Lf/'2-S I k,~r ~ Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
TYPE OF STRUCTURE.
1. Pink
2. Green
3. Yellow
File
C;ty
Contractor
Single Family
^
Two-Family
Commercial
Industrial
Public
Multi-Family
Other
Address
............o..v.a..:-..........u-....;....;.
1lINNIAPo:JS.1iZ.'11 ~'-"-
"18;1ii['"
1% of jOb cost ($39.50 minimum)
$99.50
.t64~
$39.50
$39.50
$39.50
\b,'l.@
S<;j.
Heating Contractor
8'r4l\'),Wi t!t..Q(~1:" !___~:-;n:.... r::-.~.7;=',.,~:_.JC().
Supply Openings
'el8plione# . fI' {,." ~'~r",
Furnace Make & Model ~ 33TYPE OF SYSTEM v
Mod IS' ...~ 6...' ..;,/. Warm Air Plants ^
e Ize ;'{V, a ( ~ Gravity
Conn, Lo~ f' Mechanical
Air Condkioning
Fuef\.J C.( m)FIUa~ Vent System
HEAllNG OR POWER PLANT
Steam
Hot Water
Radiation
Remember to add the State Surcharge on the bottom of this application.
Retum Openings
Input . ~ ' edU Output
. REQUEST FOR INSPECTION
SENT TO HOMEOWNER 2/03.
- NO RESPONSE. CLOSE FILE
TYPE 01
Replacement "v Co
^. ~ l"}'rue!'
Est Comp. Date q /"...., / .sO
fY) .083 I
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 !2ui!lling ImID!il ~ before build-
ing certificate of occupancy will be issued.
!::!W CALCULATIONS REQUIRED wkh 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 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) _ CALL CITY HALL
447-4230
Edr,
Cfm.
TOTAl PERMIT FEES $
.50
tJ,(J ~ eC)
Receipt' .
364-U:,
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 ~~ ;\..;;f in accordance with the approved plan in the
cas.Y1(r'err k whirzeqUirj rev~w and approval of plans. I ~
(/'~~ A ~-"V'v q j/.L-j ~
- Apr:!" ~ , Date
9 fcl- 00
Date
Akerations
Repair
Est. Cost $
HEAllNG PERMIT FEE $
STATE SURCHARGE $
I
Building Perm. ,
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