HomeMy WebLinkAboutMech Permit 02-1463
CITY' OF PRIOR LAKE
HEA TING/ AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1. Pink File
2. Green City
3. Ye\low Applicant
PERMITNO.O~_~
(Please type or print and si~ at buuu...)
ADDRESS
/e/9/7-
m~~U
ZONING (office use)
/2/50
H~ p p Cj 73vuf 'R rtfl/
fAJ ~ lJ ~ .. (Phone) ~-V'i''1.''~Y.s:
I YCJ/7 Ifl~ ~ f/lMJ1.J~.~ s:!3?:L
,
APPLICANT c uit.~ "'1 ~J n ,'7-- ~U
(Name) ~.Jm U..; ~n/C--~ (Phone) '7'1>;;" -.lJg 7-~~..("'3
(Address)-1/J~tJ1J - ~ 6tal 1-f)~~~srr3 7
(Address) ~ ~ :"'(~ity) V--' (Zip Code)
(Contact Person) ~ o-I;:J' ;~, (phone) 1J.0.. "" Jr8'IT- -;J/ S..3
APPLICANT SIGNATURE .~ DATE J/- ~-D_
APPLICANT PLEASE COMPLETE BELOW
. DNEW CONSTRucn~N . _ A KL REPLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL ~ ~J:I 00';" ~lftt ~^ FUEL Altit a a..-J
FLUE SIZE . i IJ RETURN OPENINGS INPUT /2., ~ ,..,1\ OUTPUT 2/11J J'1
TYPE OF SYSTEM HEATING OR POWER PLANT
LEGAL DESCRIPTION (office use only)
LOT q BLOCK ADDITION
PID;2S'" tJ5 3 - odi-o
OWNER
(Name)
(Address)
'KIWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. 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
Estimated Cost $
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
~ S- 9 & ~ Building Penn it #
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Building Official
Date
$ .$9" 5V
$ .50
$ 9'L'~~
Paid LjO:-
Date
/I-~{)o
Reci'!4'tlt
BY~
()
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
f)JvrMi~ 0 d. ~ I Ljft, '3
, HOUSE H ~ T~G TEST RECORD
ADDRESS ~~/ ~ APT. FLaa. CITY SUBU.B.
OCCUPANT _ _ __ _ .OWNER
HEAT LOSS _. ~9A"'E HTG INST. J . J
SOLO BY ~ ~~------ .INSTALLEaBY .q-U~.Jr~
Electrical Work By _ __ ~ ,Gas Line By
TYPE OF HEAT GA-+-FA*HW STEAM S?ACEHTR. UNITHTR. OTHER
AP J .. n GAS DESIGN CONVERSION
MAKE -PLU/ k" MAKE OF BURNER
Model ..tJ. G e It( a IS A t.J ii;. l( Mod.l
Serial .f'O(P 301 r"~ 36 --J Max. BTU RQtin'il~
INPUT --J...::>.. ~ O~}) MAKE OF FURNACE
Mod.l
<H lP CONTROLS
. 'IH~T.\" Heat Plue
Valve <..... W f<
L.1mit c'14<< ~~~ CO Co.
- w.u SeatAD. [$0
_",_ ~o
l"1UI _atADI ,
Pile:' 1'7" ()
Pilat .....
PllGf ~
Pilat 'naiaa I'
L..1f. C4 Qff '..i
?:aaaur.. ~, { I.( ~wceaI CO.. J <
. "". ;'-
!IJpuI C::H hrc.uI. Q 'D. W"
StaGk Temp. ~O 0 f:- PwCltllt Q. 0
F__=
./
11/(1"
tc
. VeaI:IM, ~
.. !COO) Oil L:N~~ JU IAl'Ir C.l~ C sa.:...k *I 'ic.'i~
. c,ait ~ ,Lp1aw
.. JlU,.,. ~ I~ 'X.'2.h ~_oH\V ~,..trl--.IC:-""'<-
.. Ca'--7 lan'.~.:)s ~
.. ~ ~jaa--ItJ,A~... ~ V"
.. I
.. ~ ~ "&rUle
.. Crei, -.., -:Oaa,
Ceer 1....... ' . QlaUaa 1aat
. Cere..... II ~..- z.. .
. Col., ...alIA; ~~ 4'tIi... 'tt~~~
. Nu. ei -:0.... :.JtJJA ' '
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
iLl q 17
2-10
(JtIU'-1 I ~7/ fZ d
SCHEDULED
OWNER
CONTR.
..,: -'ILI to ~ - :1-M/VnoM.
0\ '
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
PHONE NO.
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
o MECH FINAL
COMMENTS:
fv v V\ 4'11' / -41-u j .J.-.r, &I '--+-
/
"
~ I A(.p
L./' t vv
}:-( 4.
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
,,03
(Y'(7 ).-- /0 Owner/Contr:
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
"