HomeMy WebLinkAboutMech Permit 05-0964
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
'1. Z8. OS
~. ::n ~~~ PERMIT NO. 05. 00/-4-.
3. Yellow Applicant 7f.P
(Please type or print and si2ll at bottom)
ADDRESS
14988 PIXIE PT CIRCLE
LEGAL DESCRu'uON (office use only)
LOT
ADDITION
BLOCK
OWNER
(Name) LLOYD & JANICE SEAMANS
ZONING (office use)
PIDZ6: /'10. OOz.. 0
(Phone) --9.5.2 - 4 4...7 - R 5.5..9
(Address) 14988 PIXiE PT CIRCLE
APPLICANT
(Name) RON'S MECHANICAL, INC.
(Phone)
Q.5..?-44S-8.5...8.5
MN
55379
(Zip Code)
12010 OLD BRICK YARD RD
(Address)
(Contact Person) mJJ1ZV.J(j ~fl tt.
r"~ 1>PLICANT SIG~ATUR~ Ut&;tc..
r
APPLICANT PLE~~E COMPLETE BELOW
. DNEW CONSTRUCTION l;3 REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL IlUllfJ tihlAlO 1c/J7JJe;t- FUEL N 6-
FLUE SIZE RETURN OPENINGS INPUT IJ/);/JIJ/J OUTPUT GZ,/ oW
(Address)
SHAKOPF.E
(City)
DATE
(Phone) 952-445-8585
1/d 7JJ~
TYPE OF SYSTEM
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
DWarm Air Plants
IGr vity
echanical
Air Conditioning
Vent. System
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
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
L!6l5IJ ,tJ)
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
jqlg)
.50
iff}, aJ
,ice Use Only)
This Application Becomes Your Building Permit When Approved
Paid ~(). () ()
Dateq,3tJ .()5
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Rece~t No. 499'1/
;f
()
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~xle
ADDRESS
/t/9~~
OWNER
DATE TIME
/a~~s
,
//Cr
PHONE NO.
CONTR.
PERMIT NO. ~-9G ~
,
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 rECH FINAL
COM~TS:. / ~
,/<cp~~c~t6 ~.Y#4'~e.
I
- /' ..... I' _,,-
,/J/ t€!!'<-//Ct-I Cc! ~" ~.~4C e
~/7,t/ fi'1-4/! JV, 0 Af~OJ3
~ .1 / /
./Ze~~tlHd @r-rq,7- /cS7
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
A/
fH/C
~i.-4 __ ./
C;:~~_7Y~ ~ C?(C
/ /' _,_(1 / / :7'
~.e- / /Z~c.,J. "'_ #/c.
~;;~/ ~U';/((~~0.-2~"#'2
~? ?tJ-/e-..C '
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, C LL FO EINSPECTION BEFORE COVERING
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &I SAFETY!
HOUSE HEATING TEST RECORD
APT.
OWNER
DATE HTG. INST.
FLOOR.
CITY tJ..,( SUBURB
..,
STEAM
INSTALLED BY.
Ga. Line By _
SPACE HTR.
UNIT HTR.
OTHER _
CONTROLS
. Heat PI"9
Vent Size
ADDRESS
OCCUPANT.
HEAT LOSS.
SOLD BY
Elec~ical Wark By _
TYPE OF HEAT GA FA--iLHW
/J . j GAS DESIGN
MAKE ff /)()a MAKE OF BURNER
Model V6 f2I'/, ._~ JV1~ Model
S.ial~~F~b7-0r<f ~"'IMolC. BTU Rating
INPUT 7L?,_!J/'i') MAKE OF FURNACE _
, -
Madel
THERMOSTAT
Valve
Limit
Limit Setting
Fan Setting
Pilot Type
Pi lot Make
Pilot Model
Pilot Timing
L. W. Cut Off
Pre..ure. .9, ~ J.
l~utCFH___Jr~~
Slack Temp. '~':'-6\
Form 235
F {' 'f#!
KIND OF LINER
Draft Hood
Fi Ite,. Size
Chimney Location
Chimney Con.truction .
r '/).A 1,}/' k-
-/tfTLI' ."
Smoke Bomb
Draft
Door Pre..ure
_Percent CO2
. Percent O2
. Percent CO
~Ld
t" ~
J~ I~/~
Date Te.ted
Company Te.ting
No.... 0' Te.ter
CONVERSION
""" .,----.
IX
( ""-
6r1
(
SIZE.
----... ~ -
-","NON F/
----- Regularor
._~
" u",,", r ",...-
'nide L--'"_ Outside
0'- I/FA.7/
----
~ .Wiring_ ""
."...--.. _ T .. t Tag
g>, . R',1) r;:- L',."., ,."X
~("ii-L (f
f?/I h/
-..- . )