HomeMy WebLinkAboutMech Permit 04-0810
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
t. Zt 0 1-
r
4se type or print and siJP;I\ at b . :; . ....)
ftDDRESS
3SQ<;{ W\\\DlJJ 8eu( jf16\- S W
u::., ~~ . I PERMIT NO. CJ4. 00./ ()
3. Yellow Applicant . (/
ZONING (office
use)
LEGAL DESCRu' uON (office use only)
LOT 5" BLOCK l ADDmON W&O I.A/ s
/0-
PID zs. 108 . aa" . 0
OWNER
(Name)
.AJ \ G\( A(x\~€'[c,
(phone)
(Address) 5~ cJ::J.. U oo~
APPLICANT
~am~ Vogt Heating, Ale t PLUMBIDNG LLC
(phone) 952-929-6767.
<Address)
3Z60 Gorham Avenue St. Louis Park MN 55426'
(Address) (City) (Zip Code)
. -lContacl Person) . n ~ d. ton (Phone) q7dLi;n- 1+0 \ \
( . PLICANT SIGNATURE . . , lrd T IS 63q DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~PLACEMENT 0 ALTERA~ONS .
FYRN*I..-C lV~\h = Uv....'-JC- \ ') rA4 (f\ \v I ~ 18 Lt ao 4 Nt TO 1: d (30\ kFUEL .fl. ):14S
FLUE SIZE RETURN OPENINGS INPUT -.31.0 .AA OUTPUT f5Ct AI)
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
o Steam
I5lHot Water
rlRadiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $ '37"3 <jf - Building Permit # 0 tr. OelO
HEATING PERMIT FEE $~. SO
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ l.J(J'(:)O
Buildine Official
Date
Paid 4A}
7-'Cf\)
Date 0" L-
I u. ",..r.-
(I
ReteyNo4-?5r Z-
Bi<
o
~ce Use Only)
tis Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
HOUSE H EA TING TEST RECORD
~~~~~?1Z ~ ~ ".,yI-
HEJ..T LOSS DAlE !"lTG. INST
SDLO BY' .*,"r ~~" J'f/C
Eleetp;col Worle By
TYPE OF IiE~T GA. FJ.. HW'.1o STEAM
AUG. 17. 2004
1: 08PM
MJ..ICE
Mocl.1
S...i01
INPUT
~ GAS DESlGH
W - 1:J.G::r.:l
~g&~fp
?~
.JI. CONTROLS
THER~~I HM' PI.,.
Volvo
Lilllit . - I
Li",it S."ing _J/fI1" II
Fon Selfin, "V"'-
Plio' Typ. ~~
Plio' Malt. ~"uI
Pilo' Mod.1 S~JtJ'"
Pilot TiMing 9n ~.
L.W. Cu' OU ~.
Pt.....,. 1~" tv. e
I..p.., CFH ,.5:.5
SlOelL Telll~~.
P.re..., CO2
P.,c..., O2
P.reonl CO
.. ....
J..PT.
OWNER
NO. 530
/h'l~
CITY 'f'" SUBURB
P. 2
FLOOR
.'-~
INSTALLED BY' ""...~!
. Go. Li". By
SPAce HTR.
UNIT IiTlt
OTHER
CONVERSIOH
MAKE OF BURNER
Madel
Ma.. BTU R.'ln,
. ""'ICE OF FURNACE
Mod.1
~.
._.
Ve.., Size
KINO OF LINER
. D,oft Hood
Flit.,. A'iI Size
$"/
.q~ 51%f -S'"
---- Rotula,.r ~ .
Nu...... . '.' .
Inai". y Ou..id.
~4k~
.NONF
o.i...".,. Loco.io..
. o.i...".,. Co"s""C1ion
. s."o\r.. 8.11'I_
o..crfr
0001' P...."'.
~ 0 D.,. T..,ocI
?~'I c....,.ny T...'ing
O. 0 ~ No_ of T....,
.
Wi,i".
T.., TOll
Lightlnll In...
~41.
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,
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ADDRESS
jS9F
DATE nile
SCHEDULED ~~~
t:dt'/,{(!,~~ &4!~L ~
CITY OF PRIOR LAKE
INSPECTION NOnCE
OWNER
PHONE NO.
CONTR.
PERMIT NO. c;:J ~ - r? CJ
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL ~LUMBING FINAL
o SITE INSPECTION ~ MECH FINAL
COMM~: _ / /? ?
/ce /J ~C ~J ~~/ > ( '7:: J.-
/ .
_ i J' .A -t::' .J'
J ~~,r<: ~~-"t- /S/-V G~
A ./ 11./ /) I
7'P-~? /::5+~~T:6fA.;. /+/ve~~
0/(
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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. 40RK SATISFACTORY, PROCEED
/:}~ORRECT ACTION AND PROCEED
o CORRECT ~R~ ~~LJjOR REINSPECTION BEFORE COVERING
Inspector: f~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl