HomeMy WebLinkAboutMech Permit 05-1198
CITY OF PRIOR LAKE
HEA III ~GI AIR CONDITIONINGI flKEPLACE PERlVut
Date RK'd
/2.8.05
L Pinl File PERMIT NO
2. are", City . 05. / /08
3. Vol ow Applicant 1.
(Please type or print and si2ll at b~..w_)
ADDRESS
\~\1q r.vo.n~\uV'\ Ave Se..
ZONING (office use)
tez.
LEGAL DESCR1r uON (office use only)
LOT
BLOCK
ADDITION
PID 2.5. 00 I. 094-.0
O~ER .
(Name) G\enn a. M-\\m TOO'\j
(Address) \\0\"1'\ CCYlU'\STDV\ fr've..- ~ €.
(Phone) "\s2. 44,.. 43 ~ b
(Address)
HOME ENERGY CENTER
1 &200 25lH AVE. N /1128
PLYMOUTH. MN 55447
I
(Pho*e) .., lo~ . 4.ll. . l ~ ~ 0
APPLICANT
(N ame)
(Address)
(Contact Person) L,:.q 'io.~
-1>PLlCANT SIGNATURE ~
! (City)
(Zip Code)
(Phoq.e) I ~)O .411.0 . l ~ ot 0
VX'X iDATE '2.~
'-"IJ I
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL .bCP q VV\PV COO FUEL
FLUE SIZE RETURN OPENINGS INPUT 'BOlCO 0 OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
",warm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. 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
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 n1iilllJ1WJIlI1l11J1UIU h.cWDI_ns
$64.50 Residential, AC Only
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
....
$39.50
Estimated Cost $ 3t . SO
Building Permit #
HEATING PERMIT FEE
SI A IE SURCHARGE
TOTAL PERMIT FEE
$
$
$
0" .50
.50
40,01>
lice Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 4-6.00
Date/2.6.06
Receipt No. 5lJe/7
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
BY~
CITY OF PRIOR LAKE
INSPECT/ON NOTICE
DATE TIME
SCHEDULED ~~~
~~~~~/ ~~
ADDRESS
/ h/ /~
OWNER
CONTR.
PHONE NO.
S -/ /7'Y
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
..;7fiECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMEN~: ,. /
/4 yP HC')o"', L
/
".-.
~rlfll7~/ ..c
;--7 /' / /'
~ /oCq 7-(" C
~-L/
./
~ /'
/---: y7 q /
,
~/
C-/ (C
~6RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~ ~INSPECTION BEFORE COVERING
Inspector: /' ~ / Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
HOUSE HEATING TEST RECORD
ADDRESS \lo\.\ q ~ Av-e.. ~ APT. FLOOR . CITY RrbY L.a\(p ttt4.
OCCUPANT~n~ 8nL-\1A.~~ OWNER~ 11
HEAT LOSS DATE HTG. INST.. . U ,
SOLD BY HOME ENERGY CENTER INSTALLED BY HOME ENERGY CENTER .
Electrical Work By HARRISON ELECTRIC Gas Line By
TYPE OF HEAT GA FAX HW STEAM SPACE HTR. UNIT HTR. OTHER
MAKE'
Model
Serial
INPUT
Form 235
\,0
-~ Mr\/
~"-I.C./""'Z-'b)
~ r"\ cW.V
- .
f5,~
.~
(0:\
~
.......
THERM08"TAT Heat Plug
Valve \-\ Dv\.QAl~Q 1 I
Limit \...0~~ II ~ (I
Limit Setting _ \ S'iPo
Fan Setting -h -0}...-
Pilot Type \..-,~ 'Ll'~(O.......-'
Pilot Make L... ~~ ... L Pl f
. v
Pilot Model
Pilot Timing
L.W. Cut Off _
Pressure
Input CFH
Stack Temp.
Percent CO2
Percent O2
Percent CO
MAKE OF BURNER
Model
Max. BTU Rating _
MAKE OF FURNACE _
Model
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
_ SIZE
Regulator _
Number _
NONE
Inside
Outside
Wiring
Test Tag
I i ting InsL
HO~/~
~~-
( ~