HomeMy WebLinkAboutMechanical Permit #00-0278
CITY OF PRIOR LAKE MC
16200 Eagle Cree\: Av. S.E. Permit No. (JO-05l7~
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
1./.:J4.()O PID# ~5-140~ao~"O
6710
Lot ~ Block \
Date
Site Address
RUSTIC RD SE
Addition ()rJr.j~ .~cdJ
MOLSTON 440-9809
b:yh AnON
Owner's Name
ROB
Address
6710 RUSTIC RD SE
RON'S MECHANICAL, INC.
Heating Contractor
Address 12010 OLD BRICK YARD RD SHAKOPEE 55379
Telephone# 952/445-8585
Furnace Make & Model C-O-.V" r ,ev.-
Model Size ~~W A\J \ \ \
Conn. Load
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning 21/'2.. -to\'\. t<..JJ...U-D
Vent. System
Fuel
l)Gl
Flue Size
Supply Openings
Return Openings
Input \ \0. 000 OutputJ~: 000
Edr.
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Other Devices
Cfm.
TYPE OF WORK
Alterations
Replacement. y..
New Construction
Repair
Est. Cost $
Est. Comp. Date ~ - \ - OD
Building Permit # ()D - (\@ '1 Y'
~
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
~.6b
.50
4-0.6D Receipt#:S 73b9
TYPE OF STRUCTURE
1. Pink
2. Green
3. Yellow
File
City
Contractor
Single Family
Commercial
/
Multi-Family
Other
Two-Family
Industrial
Public
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
$39.50
$39.50
Remember to add the State Surcharge on the bottom of this application.
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 buildinq permit number before build-
ing certificate of occupancy will be issued.
HEAT CALCULATIONS REQUIRED with 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
447-9850
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.
4-24,00
~ /~ ;;on
/ ~te
CITY OF PRIOR LAKE
INSPECTION NOTICE
SeHEDU~ED
DATE TIME
s!,2..3k C)/3()
,
ADDRESS
t:, 7/ (J
~~t
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING @
o INSULA TIO
~ FINAL .
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
CJO .- ;;J. 7?'
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AI~ TST
",~F"~~ A.,c..,
./
&'"
COMMENTS:
~
~-
J41WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: ... ~ , Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
ADDRESS In'] 10 (~~C (&
OCCUPAN;fur-.. N\f)~~
HEAT LOSS . . Dt.~~ HTG. INST.
SOLD BY ~ N t;;)'€. O\t\~)
. iL".1..D,.. I
Electrical Work By _' ; \TWv,,'7
TYPE OF HEAT GA FA V HW
,
GAS DESIGN
MAKE ~~~~--r-~
Model~WA\) l\ I - \~
~'J.c;".'J:"<S
Serial ., ~
INPUT ! 0; oD
CONTROLS
THERMOSTAT . Heat Plug _
Valve ~ t
Limit '\ ~~C\.
limit Setting .~
Fan Setting _ \
Pilot Type ~
-" \
Pilot Make
Pilot Model \)./" - r: 0e..,
Pilot Timing ---""r ~ .
L. W. Cut Off
Pressure. ~&
Input CFH \tc?(fl)
Stack Temp. ~
. Percent CO2'''' "SJdJ
LlfR~
Percent O2''''::'(,:'' .
Percent CO c9 ~
Form 235
_STEAM
HEATING TEST RECORD
CITY ~L
.APT.
.OWNER
INSTALLED BY QC)NS- - fI/'---eCl-"
FLOOR
. Gas Line By
SPACE HTR,
.UNIT HTR.
OTHER
CONVERSION
MAKE OF BURNER
Model
Max. BTU Rating
MAKE OF FURNACE
Model
f II l
Vent Sin '-f
KIND OF LINER SIZF -Sit
Draft Hood Rtgula,or
Filters Size_~~ve ~V~d"'umber_
Chimney Location Inside
Chimney Construction
Outside
Smoke Bomb
Draft .
Wiring
Test Tag
Lighting Inst. _
Door Pressure
Date Tested .1!}-I:.. ?O
Company Te:ting I~"S .M-cc.h.
Name of Tester [,0 <;"~\'\l . .
SUBURB.
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