HomeMy WebLinkAboutMech Permit 02-1323
~/21/02 FRI 08:36 FAX 6124474245
CITY OF PRIOR LAKE
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CITY OF PRIOR LAKE
REA TING/AIR COND.t'llONINGIFIREPLACE PERMI1
Date Rec'd
1. l>iIlIt I'u. PERMIT
2. 0.- City NO. /11 _ / ~~
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(Please tvDe orPrinl md siu att ._....)
- ADDRESS ZONING (ofticus~) -
'1.5~~ POl\dv/ew 'rAd O$.f:. i~1
OWNER
(Name)
LEGAL DESCRu' .L ION (otl'la use only)
LOTLf BLOCK I .ADDmON {j )(/ alAvtLr 0
~ 0-
j,} 1\+~<9~
ptJ /I,II/It-vJ r; Ill! -j . t.
fS+ I>-+-
PIDdS-dfo ~O{jL/'.6
(Address)
R ober+
I{ S <..J.,
(phone) qS~- J{I.fO- '13rl./
APPLICANT .,/._ _ ~
(Name) }{./v[ VI Illllle. ;pre..
(Address) 13tJ7:5 ~Oll-ee/ ';/l,'
(Address)
(Contact Person) 7?i <: 66 It /Jrt/
APPLICANTSIGNA1'URE 'x CJ "'--^ \~
(phone) rf1eJ~ 9t/1"I/P/1
r /c:Ie/l T;A "it 553'17
(City) (Zip Code)
(Phone) 77~' ?'II-Lj~/!
DATE //).~ 7-0z"
APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION B1 REPLACEMENT
FURNACE MAKE AND MODEL t.l!1Jt1o'X., G5D 3' B O~O
FLUE SIZE 5"1 13v~1\ t RETURN OPENINGS
TYPE OF SYSTEM
OWarm Air PIlll1ts
OGravity
L'!21 Mechanic;ll -
o\DAir Conditioning
C)Venl. System
FIREPLACE MAKE AND MODEL
INPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
o ALTERATIONS
FUEL /J #f.
?l? tyCJO OUTPUT 1:5. t)tkJ
PLEASE NOTE~
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FEE SCHEDULE
Industrial. Commercial & Multi-Family 1% of jOb cost Residential, Gas Fireplace
$39.50 minimum
Residential. Heating &. Ale (New Constnlcti m) $99.50 R~identlal. Additiops & AI~ration$
Residential, Heating Only (New COrn.1\'UctiOl) $64.50 Residential, AC Only
$39.50
$39.50
$39.50
Estimated Cost-S /d(J()
Building Pennit #
HEA TINO PERMIT FEE
STATE SURCHARGE
TOTALrJ!,~FEE
$
$
S
-?9. it)
--. .50
jPtJ. at)
(omu Use Only)
This Appliestion Becomes Your Building Permit When Approved
o Buildipg Officilil
DAte
Paid I/O, -
Dajeo ~q-oJ--
~eceJpJo~ 71
By ;;J:::>./
0-
Z4 heor notiee for all insp~ctions (952) 447-9850, fax (952) 447..4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
yrc,).. P{}/\r1sUt-l wTv ~l;
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
t:'(//""Il~c.... ~
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ili'
il
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DATE TIME
16--U.
I ():' (1)
}. - /3).. 3
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: Y Y 0 { D -)...)...~ ()L Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE._
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOn
HOIJSE HEATING TEST RECORD
fOt'\clvl~ T". Sir APT.
OWNER
lo-4i -crL..
INSTALLED 8Y
c.. LI". 8,
SPAC! HTR,
t-IS-6 L--
ADORE" .
OCCUPANl
"I:"T LOSS
SOlD [IIY
Eloetflcol WIf" 8, _
TYPfOFHEAT GA. FA~W
(GAS DESIGN
~CJ"7C
r~6 (1 H '- ~A 15 -c'9()-?
"'ioz-. b brr>"O
q vOt) a
DA TE HTG. IHIT.
YAK!
....., .1
Serlll
'NPUT .
-- CONTROLS
S-"O-t;,
THERMOSTAHT Hea' 1"'"
V.,,,. IJ"'-'-'? 1/'~S?7Ail\-
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STEAM
MAKE 0' BURMeR
Me",
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MAKE OF 'URNACE
Me~11
Ve..' Sin
KIND OF LINER
D,.h Hee4
Fllteu S'.e
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