HomeMy WebLinkAboutMechanical 03-1324
DATE TIME
_CITY OF PRIOR LAKE j[J- 2'1-dJ
INSPECTION NOTICE SCHEDULED
ADDRESS I~?q( Sl(.lf~
OWNER CONTR.
PHONE NO. PERMIT NO. <,_/:1J..Lj
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
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 GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: r:-Wl/t flU
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(~~ i r~c 7'- ')
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~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ;f?ORK' CA FOR REINSPECTION BEFORE COVERING
O y.(-O),
Inspector: -i I - OWner/Contr: _
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!
INSNOTl
HOUSE HEATING TEST RECORD
)'k ,vL./iJt:. AvE N,hI I APT.
OWNER
GA
FA V
HW
ADDRESS J ,r?'!'!
OCCUPANT
HEAT LOSS DATE tUG. INST.
SOLD BY cf?Jvrt:rp~/Jv/
Electrical Work By
TYPE OF HEAT
MAKE
Model
Serial
INPUT
CA I I GAS DESIGN
/'/'I~"
18CTA-I? tJ / () II (P
~ q OJIPfJ.t /7 J
I);J () N')
I
THERMOSTAT
Val.,e
Limit
CONTROLS
Heat PI",
, . .
h j' Y'F AI
I t I 'v- CA
Limit Setting
Fan Setting
Pilot Type
Pilot Mak. I. L_
Pilot Mod.I-----L.Ld1
Pilot Timing---rTVl
L. W. Cut Off
Pre..ur.
Input CFH
Stack T.mp.
Form 235
>;3
5'u!r A0E-
Percent co ;; 1
2 /. rJ '
Percent O2 _ Vi ")
P.rcent CO r9~()J!5
d..J..J 0
err 7 r~
STEAM
INSTALLED BY
Ga. line By
SPACE HTR.
FLOOR
CITYfJ, /.., SUBURB
i /}A/ I J ~ tEe, /'"J .
UNIT HTR.
OTHER
CONVERSION
MAKE OF BURNER
Model
Max. BTU Rating ! 1 c;:, f)Or;
MAKE OF ,=~RNACE CArll t:-;<:.
Model ~8C. r-4 I '7/0/1(0
~ /1
\ r
'-.../
/'...
Dot. Tested /O'/7/c;.J
Company Te.ting /ft>,.vlj l"1~c 1'1- ...
No.... of T..ter "-P~~
../
Y.nt Size
KIND OF LINER
Draft Hood ...
Fi Iter. Size
Otimney Location
Otimney Con.truction
Smoke Bomb
Draft
Door Pre.sure
-
SIZF
- Regula,or
,Hu~er
In~de ~
n t/E JuT
Out.ide
Wiring
Te.t Ta,
Li,htin, Inst.
NONF
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
9.70.0J
I. Pink File PERMIT NO
2. Green City . /l? _I' '::''14-.
3. Vellow Applicant U...) ..;;. V
(Please type or print and si~ at bottom)
ADDRESS
15791 SKYLINE AV NW
ZONING (office use)
LEGAL DESCRu'nON (office use only)
LOT
BLOCK
ADDITION
PIDZ6J4-3.0~ 7. ()
OWNER
(Name)
RAY & SUSAN PRATT
(Phone) 952-447-5887
(Address)
15791 SKYLINE AV NW
APPLICANT
(Name) RON I S MECHANICAL.. INC.
(Phone)
952-445-8585
12010 OLD BRICK YD RD
(Address)
(Contact Person) L ,~ 1. . (Phone)
APPLICANT SIGNATURE ~~ l\LH ~ DATE
APPLICANT~LEASE COMPLETE BELOW
DNEW CONSTRUCTION ~PLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL (' 1l.\"r IJ.t" 58cn1 \ 3S FUEL J1 f4
FLUE SIZE RETURN OPENINGS INPUT r26, ~ OUTPUT leg \ 000
TYPE OF SYSTEM HEATING OR POWER PLANT
(Address)
SHAKOPEE
MN
55379
(Zip Code)
(City)
q-1.,\-{R
DWann Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. 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
Estimated Cost $
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Building Permit # 03 - /32-4-
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
~q.S)
V .50
A.D.tJlJ
"fiee Use Only)
Building Official
Date
pai~.c) 0
D27 30., () ?
Receipt ~-~ ~ ~
By 118-
/
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372