HomeMy WebLinkAboutMech Permit 02-1522
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I. Pink
2. Green
3. Yellow
File
City
Applicant
PERMIT NOO). .-/' ,5~
I
ZONING (office use)
~!SD
(Please type or print and sign at bottom)
ADDRESS
L\~~
OCLL01ld
&LUh
LEGAL DESCRIPTION (office use only)
LOT 'I BLOCK I ADDITION ~jJ 0 /YlLY
- ,
OWNER L:.
(Name) J\;\f
/ ~O)f.(-r
I
Is+-
I
h(--(L(Y1 5
pu:Q5 I 93-()o I-()
(Phone) C]2) - W - 5~/;l0
'Urv\ r(k.
(Address) ~LfY\R
~;;~fANT I'bvv(r\,~,> vi1 \{ \ HI,\ <>\ A \ C (Phone) q-:),2 - gq y . Ono5
(Address) ~q~\ fLht\A"Q :l6\alrtrt /tie, 5 ~\1~e ~3/g
(Address) (City) J (Zip Code)
(Contact Person) J\;\,L\ t. _ . (Phone) Sa,,~
APPLICANT SIGNATURE ~~~. 0 (\, ~l h'OY\ DATE \ \ - :;l 0 - ~
\) APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~ REPLACEMENT 0 AL TERA TIONS
FURNACEMAKEANDMODEL L-tfJ fJOX G 3;( \J 015. FUEL N tAl-. 3~
FLUE SIZE RETURN OPENINGS INPUT \"5) oolJ OUTPUT to C1 .' Dt,'V
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
DGravity
o Mechanical
iZIAir Conditioning Let1 tll5"f.
DVent. System 11S')( \ S o3CJ
FIREPLACE MAKE AND MODEL
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
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
~,50
.50
tiP I 00
(Office llse Only)
Building Official
Date
Paid yo, 0 U
Date 0 1
)(-;);:;- C7'-
ReCq~N?f SO
BY~
(J
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
j~-IL
ADDRESS _/Llf:?7 6i/tlcwl I1ra~h
. I Y OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
OWNER CONTR.
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
Fvvn.c c qj)
COMMENTS:
r
O~
1:1 Le
I .
~
O,...-.5q+- Y'e(,-er tl(C
DATE TIME
Lj:1/j)
~-1S-22
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
l WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: V II-{(-62- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
'4 t .~i
BUftN:!!t wILLE
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave S, Savage, MN 55378.952-894-0005
Orstat Test Report for JoW L/~ ( l
Address lY(b~l Ot'IJc~_{1 1)1't",cl ,City P(or L",--k-{
Occupant tt ;11 t'lA / fr /( v"\ 5
Date of Install I z,. . (,. D L
Type of HT, F/A \./ HW Space HT Unit HT
Other
Make
Model
Serial
Input
Ul/\/tU) (1
&i2-\/J-(jivC G, i
"'----:-
5~o2.:r t.Is:,l/
'1 '5, tOD gtVt.-/ I
cp
Pilot Type HOT SURFACE IGNITOR
Pressure 5 \' . C02 ~ {(
Input CFH 'I 5' 02 g'.l:::,
Stack Temp 12--- CO D
f7,b-oL
Bate Tested
Company
Technician
BURNSVILLE HEATING & AIR CONDITIONING
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