HomeMy WebLinkAboutMechanical Permit #01-1111
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
(Please type or print and sign at bottom)
ADDRESS
4!:iY 0 (' D I Ov c.x.d.o 'S t-', .
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(N ame)
-s~c; ~()d (LWcJ&
(,
(Address)
APPLICAN~
(Name) , hJ'{ Y"'\~~\ \ Lo \-\.a..o.::hYV.\ ~ iA\L
(Address) I~ Llf I ~ Lsl~d-~- S '
(Address)
(Contact Person) /J 1 n
APPLICANT SIGNATUREY-PI b-t0
Date Rec'd
10-5-01
,
',"..iJ""f
I. Pink File
2. Green City
3. Yellow Applicant
PERMIT,rlOI_1111
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:~.:3}}'
,~.i,: ';.1'
ZONING (office use)
1<2-
PID2.5 -005 - 0/7- 0
(Phone) 9 Sd.-lfLI) ...13S I
(Phone) 9~a-~9'-/-o~
(City)
(Zip Code)
(Phone)
DATE
10/0 <\
l, -
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~PLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL l.eJl("\D){ ~V<~-IS FUEL tJQ..+~ (letS
FLUE SIZE l.J II RETURN OPENINGS INPUT '-to/OOD OUTPUT
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
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
TYPE OF SYSTEM
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial & Multi-Family
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $ -'JJ6DO 00
$39.50
$39.50
$39.50
Building Permit #
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERlVlll FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
$
$
$
39, CSU
.50
1I0100
pa~. (2{)
Date
If) · 5' · 0 /
Receipt ~~~4--'
Bptc-
DATE TIME
CITY OF "PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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ADDRESS
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~
4r<
OWNER
CONTR.
PHONE NO.
PERMIT NO.
"1- 11/1
o FOOTING
o FOUNDATION
o FRAMING ~
o INSULATION
~ FINAL
, ] SITE INSPECTIO
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:~~
(7/~ ~
~~,
~ WORK SA TISFACTORV, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~ALL FOR REINSPECTION BEFORE COVERING
Inspector: r. ~ I Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
BUHNSVILLE
Heating & Air Conditioning, Inc.
12481 Rhode Islarul Ave. So., Savage, MN 55378 · 894-0005
Orstat Test Report for Jobl
7G7 b'"
Address e~ 10() tl Cily frL(
Occupant L(40 ~/b/I"'C.~O A LJ e
Date of Install
Type of HT. F/A I" HW Space HT Unit HT
Other
Make -!-~~~
Model~~. 7 ~ _ S'
Serial .s<:?"O[ +I- %077
Input 7$'"", c)oc>
I
Pilot Type
Pressure
Input CFH
Stack Temp
tb\!- 5 ~ r-P
~.2
13 ~
C02
02
CO
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c: ~CJ
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DateTested /~ -(<3" (5 I
Company
NameofTester~ ~