HomeMy WebLinkAboutMechanical Permit 03-1331
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
p,/J ftt/
ADDRESS
S-70~ - ~ ct.#V~t::/(:) L /r/
/ ' ,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~LUMBING FINAL
/ MECH FINAL
COMMENT9i ~ --'"
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C;~60~0R
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3 . 1531
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~ORK SATISFACTORY, PROCEED
~ ~lI~RRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
/NSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
03-- /53/
_ ~JOUSE HEATING TEST RECORD
ADDRESS s2qs- C~II1Y" trJft"{)f f,.... APT. .FLOOF ,CITY p.l. .SUBURB Pt. (
OCCUPANT !:ft,h mill €....< OWNER ~ h M I ~/Ie"....
HEAT LOSS DATE HTG. INST. . "-d.J-~'1
SOLD BY t",;s ~,(IJ.-J,aA'~1.. J INSTALLED BY _
EI.ctrical Work By &,w<?, ~ g.~ Ga. line 8y
TYPE OF HEAT GA _ FAX HW .STEAM. SPACE HTR. _UNIT HTR. _OTHER
MAKE
Model
Seria I .
INPUT
Le:i\ '(\~:iJAS DESIGN
GhC)/.~B- 36~ -070
SlC>~.i~~~
r--__.__ ~TROLS
THERMOSTAT~ \ H.at Plug,
Va Iv. .
Limit
Limit Se"ing
Fan Setting.
Pilot Type
Pi lot Mak.
Pilot Mod.1 .
Pilot Timing _
L. W. Cut Off
Pr...ur. _
Input CFH
Stack T.mp. J J S--
Form 235
\/
X
/ \
P.rc.nt CO2
P.rc.nt O2
Percent CO
bt'-f
q l S-
.MAKE OF BURNER
Mod.1
Ma.. BTU Rating
MAKE OF FURNACE
Model
Vent Size _
CONVERSION
/
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r,\
b
t'("
KIND OF LINER SIZE
Draft Hood . R~ulo,or
Filters Size /GpS:X~Numb.r
Chimney Location Insid.. . Outside.
~-""p~
'\
Chimney Construction
Smoke Bomb _
Draft
Door Pr.. .ur.
Dat. T..t.d _
Compony T..ting
Name of Te.ter
NONF
/(
'-
Wiring
T..t Tog
lighting In.t.
-;\
({I!J h ~ /J1 e., C ,
. h1 I' I<t! -
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
(please type or print and sign at bo~..&&< H 0 MEO WNER 11/03
ADDRESS
Date Rec'd
1. Pink
2. Green
3. Yellow
File
City
Applicant
PERMITNO.03_ /331
ZONING (office use)
t/5fJ
141B] WATER~ BB!. T~AIL~ ~~o~ J
f ~ d fA./i tJ,(Y( )t1
LEGAL DESCRIPTION (office use only) (!,Lf./t -7 Y , d J tJ - 0 :3"3 - 0
LOT \d'BLOCK '3 ADDITION ~ ~um fJOI-N+e- 3 rd PI085'I#.~1
I
&'~
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~REPLACEMENT D AL 1 bAA TIONS
FURNACE MAKE AND MODEL .-e,.nnox Q:\ f.4DU~.01O. FUEL
FLUE SIZE RETURN OPENINGS INPUT ~. f)() D OUTPUT ~
TYPE OF SYSTEM HEATING OR POWER PLANT
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
.BeB-M~I,I,ER-
OWNER
(Name)
(Address)
BOB MILLER
14359 WATERS EDGE TRAIL
APPLICANT
(Name) RON'.:S MECHANICAL, INC.
(Address)
12010 OLD BRICK YD RD
'- (Address)
(Contact Person) ... \ YVia,
~PPLICANT SIGNATURE ~ \ ~
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
(Phone) 952-445-4108
(Phone) 952-445-8585
SHAKOPEE 55379
(City)
(Phone)
(Zip Code)
'-\'1~
\D - 1-03
DATE
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Estimated Cost $
Building Permit #
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
flee Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
$
$
$
?A. cg)
,\- [J
'-IU.V
Paid '(0.------
Date It) --?-3
Recei~53 fh
BYW .
o ---
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372