HomeMy WebLinkAboutMechanical Permit 04-0052
CITY OF PRIOR LAKE
HEATING/AIR CONDI lIONING/FlREPLACE PERMIT
6umsville Heating & Ale, LlC
12481 Rhode Island Ave.~.
Savage. MN 55378-1122
(Address)
(Contact Person) J LlL' l-, , -. _ _
/r-'''PLICANT SIGNATURE / v1J tL. ~ /rtr:rY'
u V
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~ REPLACEMENT D ALTbKA TIONS
FURNACE MAKE AND MODEL ~ r; 4DUtJ ~(o A 0"-'0 FUEL rJ J.. qtl;)
FLUE SIZE RETURN OPENINGS INPUT ~ 01JlJ OUTPUT ~CIJ
n.t'~ OF SYSTEM HEATING OR POWER PLANT
(Please type or print and sip at bottom)
ADDRESS
Nfl ve5> 1(.
LEGAL DESCRIPTION (office use only) 0 /J
LOT !l BLOCK 4 ADnmON ,..A-ft~lf.o..
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9S2--l.fcf 1- %?!?I
SE
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OWNER
(Name)
5u'~
~
(Address)
APPLICANT
(Name)
(Address)
Date Rec'd
Z. 3. r;;4--
~: ~ ~:~ PERMIT NO. A.,I.,-^",r~
3, Yellow Applicant ~ ~ ~
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prq;~-1t,5--()to6 -V.
(Phone)(f5Z- 44'7 - D;;1.77
fA-I
(Phone)
(City) (Zip Code)
(Phone) Q72-.gcj'{-OOOS
DATE 1/30 /0'1
OWarm Air Plants
o Gravity
o Mechanical
OAir 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
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
/1/}f-1tOO .A_ 5
~UI BuildingP"uuit # o~ Of) 2-
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
~
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERl\'.l1.l FEE
,..,iliee Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
$39.50
$39.50
$39.50
$
$
$
3cr. 50
40 c)(J
. (
Paid 'f(), () ()
Date "? () 4-
Z.V~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
.. ~clTY OF PRIOR LAKE
INSPECTION NonCE
DATE nilE
SCHEDULED
~/74'l ~H7rJ
ADDRESS
Sip S-f
~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
tJL/-O()~z,
[] FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECnON
COMMENTS:
[] PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~ MECH FINAL
o EXlGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE ANAL
o GASUNE AIR TST
o
~,~~t;~:~::r'"~ '-:' j _ ';t
;"iir,/'", -, ~ p.
\......;'"
-
~~
II WORK SATISFACTORY. PROCEED
(~ CORRECT ACTION AND PROCEED
o CORRECT ~ALL FOR REINSPECTION BEFORE COVERING
Inspedor: rL.f I Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
UtSNOT1
'i'BVftJ'Nj,tfB1.~LE
Heating & Air Conditioning, L.L.C.
12481 Rhooe Island Ave S, Savqge, MN 55378 · 952-894-0005
Ors1at Test Report for Jobl
Address 64:S~/#l~~'~.Ci1yh?~~
Occupant ~" ~~ ~~ /
0&1801 Ins1al1"~ 0 ~~
/ // /
Type of HT. FlA V ., HW Space HT UnitHT
Other
Make 7~~~)C'
Model C:;~UH -3C,/I- 07CJ-07
Serial 580.y~3/$O/
Input ?o.J~
Pilot Type HOT SURFACE IGNITOR
--"
Pressure --E,5 CO2 ? · ~
Input,CFH?6 02 /0
S1ackTemp 3/3 CO /~~~
Date Tested ~4/
Company BURNSVILLE HEATING & AIR CONDITIONING
Technician 3;;1-. ~
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