HomeMy WebLinkAboutMech Permit 05-0686
CITY OF PRIOR LAKE
REA TINC/ AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
7. /8.05
(P1eaae type or print and sian at 1 ..... .. ..)
ADDRESS
\4~ ~ple TYl1\\
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 11/05
.ink File
lreen City
(ellow AppIiClDl
PERMIT NO. a5. ~ " 8 ft,
ZONING (oftic:e use)
S~
LEGAL DESCRu- nON (office use only)
LOTti BLOCK 8 ADDITION
/!Jr~ ~ L/~ PID)B g () ;;;g--O.
-\
OWNER
(Name) :f\t<\... :\u\r p, r~~
(Address) '4~ W\a~~~i \ ~
(phone) "52 .44, . .31?) OJ
APPLICANT
(Name)
(Address)
HOME ENERGV CiNlii
1ame 25tH AW. N 'lU
PLYMOUTH. UN .....,
(Phone) ..., 103.~' ~. \Cfct b
(Address)
(ContaclPenon) Li_~
(~PLICANTSIGNATURE _' ~ ~_
. -, V\J
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 5(REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL :t:cP<6mPV\(X) " FUEL
FLUE SIZE RETURN OPENINGS INPUT \t:O,C'i')(.",\ OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
dWarrn Air Plants 0 Steam
DGravity 0 Hot Water
o Mechanical 0 Radiation
DAir Conditioning 0 Special Devices
DVent. System 0 Other Devices
(City)
(Zip Code)
(Phone) l \Q ~ . I{ '1 \0 . \ Cf. ct t;"'\
DATE I. \4.0S
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50 Residential, AC Only
$39.50
Residential, Heating & A/C (New Construction)
Residential, Heating Only (New Construction)
$39.50
Estimated Cost $ \ \1~.OO
Building Penn it #
,~
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
81.50
.50
-40.00
.fiee Use Only)
Building Official
Date
Paid +0. () 0
Date-Z /8, () t:}
Receipt No. ~dt.:?
By j$<-
This Application Becomes Your Building Permit When Approved
24 hour notice for aU inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
DATE
/~~b
./
/~'.53 ~/Jk 7'//
&NTR.
s-- b r6
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL 0 PLUMBING FINAL
o SITE INSPECTION ~CH FINAL
COM~~TS: _ / ~
~_//~/1 ~r;1~C-e..-
. / /
./ 11.....,.. " .'
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
PHONE NO.
PERMIT NO.
.4 ,,/'
C/~0J~-/r:.d
/ .
4q,/ a{
./
TIME
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/
rmC/
J
Lit
I
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK,C .;~ 7EINSPECTION BEFORE COVERING
,__ tyV Y. QwnerfConl<:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
IJISNOTJ
5 ~ Grt~
. APT.
OWNER
FLOOR CITY 'P'lOV La.~c.
~r~
STEAM
_ INSTALLED BY
_ Gas Line By
SPACE HTR.
HOME ENERGY CENTER
. UNIT HTR.
OTHER
(J
He:- . HEATING TEST RECORD
ADDRESS \L\IQ:O~ ~\t:.1'rri\ \ ~
OCCUPANTT\~\ ~ \P.~
HEAT LOSS DATE HTG. INST
SOLD BY _ HOME ENERGY CENTER
Electrical Work By HARRISON ELECTRIC
TYPE OF HEAT GA FAX HW
MAKE
Model
Serial
INPUT
l cP
KMrv
1\-0,," \.t) (/ d S'l/
, 0 0 _ /"">1'""),)
THERMOSTAT Heat Plug
Valve \\ D~ \.AJ..Q l \
Limit ~O\.tiU..o w.c>\ \
Limit Setting _ , ~ D '
Fan Setting -h \n-l.A
Pilot Type ~ S::J-. c::... ~..., h("~
Pilot Make V\ Q ~ ,.J.,)-Q II
Pilot Model
Pilot Timing
LW. Cut Off _
Pressure
Input CFH
Stack Temp.
Form 235
c8.-S-
--7<'
r P -::;-
Percent CO2
Percent O2-
Percent CO
-
k,
<:;"
'0
_ MAKE OF BURNER
_ Model .
_ Max. BTU Rating
_ MAKE OF FURNAGI=
Model
Vent Size
I KIND OF LINER
Draft Hood
Filters Size
Chimney Location
Chimney Construction_
I Smoke Bomb -
Draft
I Door Pressure
_ Date Testerl
Company Testing
Name of Tester
_ SIZE
_ Regulator
Number
Inside Outside .
Wiring
Test Tag
Lighting I nst
HOMEE~NTE~
- ~
c7
~
_ / 6
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