HomeMy WebLinkAboutMech Permit 02-1231
CITY OF PRIOR LAKE
HEA TING/ AIR CONDITIONING/FIREPLACE PERMIT
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ADDRESS
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Asp~
Date Rec'd
I. Pink
2. Green
3. Vellow
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.~!~. I PERMIT NO. /'1 '
Applicant I '!-
ING (office use)
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LEGAL DESCRIPTION (office use OnlY)!J I
LO~ BLOCK b ADDITION cZ7)::i/rlcJ/ fJ~ ,~r<d-
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APPLICANT b.. _ __ ~
(Name) l~ nsu \ ( I~ i-f t--'d-
(Address) '~'-f.~( p.,hoJ.;~ ~ ~\~
(Address)
(Contact Person) "-f 'TA..Jcv R,,~
APPLICANT SIGNATURE ~ ~, R.~ DATE q- ct., - c ~
APPLICA~ PLE~SE COMPLETE BELOW
DNEW CONSTRUCTION ~PLACEMENT 0 AL TERA TIONS
FURNACEMAKEANDMoDELLehln6~ G~- OlOFUEL ~~
FLUE SIZE RETURN OPENINGS INPUT :J..O CeJO OUTPUT ~ Y. Qr\()_
TYPE OF SYSTEM HEATING OR POWER PLANT
OWNER
(Name)
YY\ (~ l1..-c..
\ 4-o~
(Address)
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
PID a.5- d-/t/-()5/-(')
(Phone)
q 5~ ~l.f-C()05'
(Phone)
~ So S~VV\:q~
(City) l\ (Zip Code)
(Phone) q 5 a ~~t.f --000 5
553~
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
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
$39.50
$39.50
$39.50
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
$
$
$
34 ~5o
. .50
<<+0-00
Paid (j() I -----
Date ~ ___
~
Rece~5J
By ft/.
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BVRN~"ILLE
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave S, Savage, MN 55378.952-894-0005
"
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Ors1at Test Report for Jobl i/.3 <i 7
AddressJ!l ~K~ ~'^ Ac.J'P City.l1.'or LAiJ:
Occupant ft71.t~ ,RA-t.- /(:1 (
Date of Install /0- ~- 0 t....
,
Type of HT. F1A"--- HW Space HT Unit HT
Other
Make D L~/1;l^V
Model $ 6 QU ti 'rJ - 070
Serial S-YO<.. :r J ~ '7/
Input ::b - a:r" -
,
-'" ~
Pilot Type HOT SURF..ACE IGNITOR
Pressure S, S- C02
Input CFH ?o~ 02
,
SlackTemp ~2~ CO
~c.
'.4{
~
j
11
/
Date Tested
Company
Technician
BUi/NSVILLE HEATING & AIR CONDITIONING
bAIl! .;tfA4t:J}~
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D~ TIME
CITY OF PRIOR LAKE
" INSPECTION NOTICE
ADDRESS t"L{3 g,.,
OWNER
SCHEDULED ~t~~
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PHONE NO.
CONTR.
PERMIT NO. ~) 2.. -l2...3 I
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
, .Mt::...n "'11't~L
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
r~1;~
q-r V
COMMENTS:
C'"~~
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./11,.1/4 '--' - ·
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O//"lc,e.
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o WORK SATISFACTORY, PROCEED
4A.feo ECT ACT
C~ORRECT WORK, CALL FOR REINSPECTION BEFORE COVI:I'I.II~"'-:::::'
InSp:Or: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
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