HomeMy WebLinkAboutMech Permit 06-0216
CITY OJ,;"' i~l.. KE
HEATING/AIR CONDITIONING/~'IREPLACE PERMIT
Date Rec'd
3 d'l OC:
(Please type or orint and siJ!)l at bottom)
ADDRESS
Sf- flu
3f{J~
/70 0
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER --;:)
(Name) l.J r LA- L e
(Ad~~essJ ~ J 0;) / "/ c)
Gh/r!YS
~ S;~ Jid
APPLICANT
(Name)
BURNSVILLE HEATING &AJC,INC.
"401 VV. ~urnsvllle Parkway
Suite 120
Burns:till9rtMN 55337
(Contact Person) (' (\
APPLICANT SIGNATURE cJ/L,( I.Lt-l ,.-J?(.-t4/
(Address)
~. ~::n ~:~ I PERMIT NO.O/ 02/ r I
3. Yellow Applicant lP. lP
(Phone)
ZONING (office use)
. i ,....,
/C c:-
PID 25 2-~ 7 GO? (:I
dl/)s~~LI b t.J-S
(Phone)
q~ d- J c;,/ C'CC S-
(Phone)
(City)
{jJ- J
(Zip Code)
S'C) $" 0 00 5-----
3'-;)7-06
APPLICANT PLF{,1\SE COMPLETE BELOW
DNEW CONSTRUCTION ~ REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL L~.A/G!;L~X ~:so b p ~4-A - 0 '-/-!-:' . FUEL Jl.IA r ~ S
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
DATE
TYPE OF SYSTEM
DWarm Air Plants
DGravity
~ Mechanical
~Air Conditioning
o Vent. System
REA TING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
$39.50
Estimated Cost $
Building Permit # Ci (, 2./ &
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
'()ffice Use Only)
his Application Becomes Your Building Permit When Approved
Building Official
Date
$
$
$
3crsu
.50
.zit:. 00
Paid
4- (.I ClC
Date
..3' Zr.~ O~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
Receipt No. ,,- /J'~' (-)
~:';;/'v,'/
By $ltt~
/
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~kh
, /
TIME
ADDRESS
3 YO ~
/7d/h
s/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
h- 2/(,
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
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
/? /;7 74
C~h~7/~ ~~ ()
/...( ../A r-t:::' Vc, ~ ./L-e Yc:'X/~
/" / .
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, ~)rOR REINSPECTION BEFORE COVERING
Inspector: /f'~ ~ Owner/Contr:
. v
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
BVRN~"ILLE
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave S, Savage, MN 55378.952-894-0005
G--:;- --, .-
Orstat Test Report for Jobl {,;;/ _./~ <~
AQdress;-; ,) -; / .J ,51."1.../' City ,Po _ / / 1<,
A" .
Occupant )Ii! (" e / c"" j,- t: --'
-~
Date of Install~; ., ;<)
Type of HT. F/A V HW Space HT Unit HT
"
Other
Make
Model
Serial
Input
-\
. ,-....,.,.
{ "
e::;, 1,' 6 (1 +.
LI4-
[':>:; ,.....,
;q f __ _
/') (/-~. ) -? ('.-.'~
,/ 'i-.- / __/ :-
LI
0(-,/<:---::>
Pilot Type HOT SURFACE IGNITOR
Pressure -5 . '-,> C02
1-1 r
Input CFH (C> / -DC.....,l.':> 02
Stack Temp .3;J ,;/,2> CO
?
5: ~;-~'
f ,!) P ;,,-,
" I
Date Tested
'7 <,
::> _~I .,:>
Company BURNSVILLE HEATING & AIR CONDITIONING
Technician .~...- \~
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