HomeMy WebLinkAboutMech Permit 05-0049
DATE
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. \IF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~?O
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
o PLUMBING FINAL
~CH FINAL
--
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TIME
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o EXIGRADlFllllNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~~CI e,J7~
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~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~.:., C~rOR REINSPECTION BEFORE COVERING
Inspector: //'f/%.- Owner/Contr:
"
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
I/ISIIOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
J.ISJOS-
I. Pink
2. Green
1 Yellow
File
City
Applicant
PERMIT NO. 05. 004Lj
'ase type or print and SiWl at bottom)
.JDRESS
4170 COLORADO ST SE
ZONING (office use)
j0(JO
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID Z,S', DOC" 030. ()
OWNER
(Name) CHRI STOPHER JONES
_ (Phone) 952-226-3025
(Address) 4170 COLORA DO ST SE
APPLICANT
(Name) RON I S MECHANI CAL, INC.
(Phone) 952-445-8585
(Address)
12010 OLD BRICK YARD RD
(Address)
SHAKOPEE MN
(City)
55379
(Zip Code)
APPLICANT SIGNATURE
. (Phone)
DATE
(Contact Person)
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~ REPLACEMENT D AL TERA TIONS
. LlRNACE MAKE AND MODEL --Lo J\'\ (\O'i G . ~ J \f\ Q- ?tof> - 6tO FUEL
FLUE SIZE RETURN OPENINGS INPUT ::}o ,0(.)0 OUTPUT 19~ - I./{::i)
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
DGravity
~ 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
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
$39.50
$39.50
Estimated Cost $
Building Permit # 0500+r
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
!A!D
.50
At) .ro-
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid -fO. 0 ()
Date/. /+, OS-
Receipt No, 48&~/
BY_~
/
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
ADDRESS
OCCUPANT
HEAT LOSS
SOLD BY ~,/I
Electrical Work By
TYPE OF HEAT
HOUSE HEATING TEST RECORD
'1170 ~W''''<bod1:.~ 5+-. 5"E APT. _FLOOR
OWNER.
DATE HTG. INST. I..., 't. - a~
. s /VT,-c;. /, co /'I I rs. I INSTALLED BY R~~, 5
Po ~r J....... ~s.:.- Gas Line By
_ FA L- .HW _ STEAM SPACE HTR. _
O'A
UNIT HTR.
GAS DESIGN
MAK E t.... e "" .;'l .a.....
Model, G r/.N"/ P - 3t,,$ - 07.0
Serial. S-~04 L I ~ ;oa.,
INPUT /O.aoo
_MAKE OF BURNER _
_ Model _
. Mox. BTU Rating
_ MAKE OF FURNACE
Model _
CONTROLS
THERMOSTAT D.;. .~+-.J Heat Plug
'"
Valve,
Limit _
limit Sa"ing .
Fan Satting
Pilot Type _
Pilot Molee
Pilot Model
Pilot Timing _
L. W. Cut Off
Pressure
Input CFH
Stacie Temp.
Form 235
Vent Size,
,'~ PU<-
AI..... "'""
CITY f. L.. _SUBURB
/V1 ~ (0 t... ~>. co_I
~'
,OTHER
CONVERSION
~/
, ,
, SIZE~ CI
1 ~ L -()
t' Y'..\-r
C
KIND OF liNER,
Draft Hood Re,ulator
Filters Siza~7a~ LNumber
Chimney Location Inside
Chimney Construction
~T
- ~
~ iAft\-A1 ~
'r-
Smolee Bomb
Draft
r\'
. Door Pressure
~ Date Tested
~'" Company Testing
,~ Na_ of Tester
6;-t:y- .:.
l., '7
?O
:3
~'1. , /?'
NONE'
Outside _
Wiring
Test Tag
Lightin, Inst,
rt-
-/7-05-
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