HomeMy WebLinkAboutMech Permit 05-0891
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
9/ '1-. u>
~. ~~n ~!~. I PERMIT NO'ag- 00.011
J. Yellow Apphcant . (/-,
(Please type or print and siJlll at bottom)
ADDRESS
6781 Boudin St
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDC.S': ZCO. (JOB. 6
OWNER
(Name) ~ob9rt And JlIr.2 ~~!i t,-k
(Phone) -957;,,;~
(Address) h7Al Rnllnin St
APPLICANT
(Name)-!:lom~ ~noV'(I}1 rontoV'
~ v_
(Phone) 763-476-1990
(Address) l5200 25th Ave Nort~ ~1J.ite 1?A
(Address)
Pl yroOlitl:l J MfII 1;1;447
(City)
(Zip Code)
(Contact Person) -L i~! '!'-Ml~ (Phone) l.h1-47...h-1Q9.o
, ,{,PLICANT SIGNATURE ~.. YM DATE 9/12/2005
APPLICANTV~ASE COMPLETE BELOW
DNEW CONSTRUCTION !UREPLACEMENT D AL TERA TIONS
FURNACEMAKEANDMODELJllnitrol GMS 80?Q FUELN}IItllr}lll Gl'lc:.
FLUE SIZE RETURN OPENINGS INPUT 70,000 OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
[]IWarm Air Plants
DGravity
o 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
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 - ,JIll 11Tt:l.~ rmll .~. ations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
--,
$39.50
Estimated Cost $ 4830.00
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3Q_50
.50
40.00
lice Use Only)
Building Official
Date
Paid 10,,"--
Dateq ./OS
,/'1.
~i~ No. -tf~1
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
b/ ~/ &sfw'Lh
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
COMMENTS:
~ . (' ;r
pee/veal O~T
-----
..J1I'r .J
DATE TIME
4~~\-
S--cf'7/
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~/
---.....
" )
./
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
INVIOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
HOUSE HEATING TEST RECORD
ADDRESS 10":1~\ &-.uti,,,,, "ST
OCCUPANT Or-4QeY+ ~t 0\AY\P-
HEAT LOSS DATE HTG. INST
SOLD BY. HOME ENERGY CENTER
Electrical Work By HARRISON ELECTRIC
TYPE OF HEAT GA FAX HW
MAKI=
Model
Serial
INPUT
$vi -\d..\c::...
'--- \~ , "t-lLd-
Cb.~ 8"D
o S t!:::>~ CXa z.. I ( ,
A.:..> "--~.....,
,APT.
. OWNER
STEAM
, INSTALLED BY
, Gas Line By
_ SPACE HTR.
FLOOL.
S\r, u;t~
CITY B- i ~y
la.~,
OTHER
. MAKE OF BURNER
. Model.
. Max. BTU Rating
. MAKE OF FURNACF
Model.
THERMOSTAT . Heat Plun
Valve , \ru:~~ ')-0. '..I -
Limit, ~A-C::; ~
Limit Setting 2-~
Fan Setting ~ ~
Pilot Type ~ ~. C' ( A. ..-fc. c~
Pilot Make
Pilot Model
Pilot Timing
L.W. Cut Off
Pressure
Input CFH
Stack Temp
Form 235
7~
:t;l <'
7~,
L-
'0
'u
Percent cO2
Percent O2
Percent CO .
. Vent Size
. KIND OF LINER
. Draft Hood
. Filters Size
. Chimney Location
. Chimney Construction
. Smoke Bomb
. Draft
. Door Pressure.
. Date Tested
. Company Testing
. Name of Tester
HOME ENERGY CENTER
. UNIT HTR.
SIZE
. Regulator
Number
Inside,
Wiring
Test Tag
I .ighting Inst.
~
HOME ENER~ ('~
g~
.~
NONF
Outside ~
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