HomeMy WebLinkAboutMech Permit 02-0885
CITY OF PRIOR LAKE Me
16200 Eagle Creek Av. S.E. permitNO.~-P.8'...5""'""
Prior Lake, MN 55372 .-
HEATING APPl1CATION I PERMIT
7- /8-o;;L PIO# ~s- 13g-f)d7-()
/"/ tf /3 /na/)/e 7ra: l ..J"; E,
Addition (I aItICVJ1 d hCtelv ?- Jndustrial, Commercial &. Multi-Family
't---. L..- -L ' Residential, Heating & AC
Owner's Name ..J...,JeJ U CI - r r -; t:l r 7 / I?
J Residential, Heating Only
Address / "r F / 3 h7 ~Je ~a ~ I S, E r Residential, Gas Fireplace
p r- ~ 0 ,... Z e>-.- k' <- \ Res;J...., .lial, Additions & Alterations
Heating Contractor ...t::P ~l t~ PeP -I-~ n ~ V- Ai r ...)er,), C~~ ::lilc, Residential, AC Only
Address 1~91.;l Ve-n-fu ra.. ~l.t 1""'7- ~ ~ +c.,2( .
..s/he;..ko tD e~ h7 A.J ..:i-S- ~ 7 ~
Telephone' , CJ.r.;2 - 0/03 -//.ID .
Furnace Make & Model .carr;~r TYPE OF SYSTEM
~Il tr> v PICO-l-:l/J Warm Air Plants
Model Size 1001 aOO iS7'to(.. Gravity
Mechanical
Air Col'iditioni,g Carr,' t. r .33n.~()3'"
Vent System
HEAllNG OR POWER PLANT
Steam
Hot Water
Radialion
Special Devices
Date
Site Address
lot
Conn. Load
Fuel
1\10..+.
Supply Openings
Return Openings
Brock
'7 tr
Flue Size ~
/9 " X /9.J/.r n
J~ Y.: y~3 '/'1'"
Input. Irx>; Oeb OUlp'Ut-W 000
Edr.
elm.
A~erations
Other Devices
TYPE OF WORK
Replacement )<.
New Construction
Repair Est. Comp. Date
Est. Cost $ ~ J SO. t>O Building Permit ,
HEATING PERM1T FEE $,
STATE SURCHARGE $,
TOTAl t't:HMIT FEES $
..3 9.- SO
.50
Lj 0 . CJO _ Receipt # t/;;5'31
TYPE OF STRUCTURE
1. Pillk - FIl..
2. Gr",,,. - ell)'
}. Yellow - ContraclCl1
Single Family
>(
Two-Family
Multi-Fami'y
. Other
Commercial
Industrial
Public
Fee Schedule
1 %. of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Remember to add 1he State Surcharge on the bottom of this application.
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections will be billed at $35.00 each.
House Heating Test Record must be submitted with puHding gmmj nu mbar before build-
ing ceriiiicate of occupancy wiil be issued.
tiEAT CALCULATIONS REQUIRED with number of supply and relUrn openings listed per
room with CFM's per opening. New strudures or additions send Door plan with supply
and return locations shown. HEAT lOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE. 16200 EAGLE
CREEK AVE. S,E. PAlOR LAKE. MN 55372.
City Halt business hours are 8 a.m. - 4:30 p.m_
ALL WORK MUST BE INSPECTED (ROUGH-JN AND FINAL) - CALL CITY HAll
....7-9850
j hereby apply tor a mechanical systems permit and ! acknowledge that the
information above is complete and accurate; thai the work will be in conformance
with the ordinances and oodes of the city and wHh the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDI NG
OFFICIAL; 1hat the work wm be in accordance with the approved pian in the
case of all work which r Ruires review and approval of plans.
a ~ , 7- /~_p.2-1
Applicant's ~ature Date
~ ~ 7-/g"~
BUildirpJr"cal'S S;l:I' ,...;ure Date
?/I-~Z:'3o
rvt~ J ~ ·
. LAKE
.....N NOTICE
SCHEDULED
ADDRESS
1'1 &>13
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION @J
o FRAMING
o INSULATION
INAL
~ITE INSPECTI N
COMMENTS: ~:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
\
~
(1
J ." a
l~~
DATE TIME
IJ z -CXgS-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
'" WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
'",peetoc ~, Qwne,lCo"',
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
I/'iS/'iOTI
Oualitv Heatine & Air Services. Inc..
952 403-1110
APPLIANCE PERFORMANCE TESr
ADDRESS/fy/3 !!1Jy k. TA ~
Tester ~ /H<.., ~s
I
Date g -f-o~
Percent 02
7.~
39
10,7
9~t)p
PPM co
Percent C02
Stack Temp.