HomeMy WebLinkAboutMech Permit 02-1523
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please type or print and siM at bottom)
ADDRESS
0IL.L- Mai U\
~,~;e:n ~:;y I PERMIT NO. 01 - 1<'])-:;)
3, Yellow Applicant c:^ J q---..:J
C /; [A~
ZONING (office use)
1<)
LEGAL DESCRIPTION (office use only)
. LOT~OCK f ADDITION a/{LWN ()~ d Ail
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OWNER
(Name)
5 .\- e", e.,
<7 CV(y\.i
I
PI~ - /~./)-{[J s- -d>
- -
(Phone) q~-447.- lJq 8<6 '
, (Address)
~~~~~ANT &LYYl~ \[) , \e ~\q " -.\- Pr G (Phone) Cr 52 - <6CJlf - C?C?5
(Address) '~4~\ Q/M~\L Ss\!QN\J 1Nt, S, ~\Jaqe. es~37g
(Address) - . (City) I (Zip Code)
(Contact Person) J lA L.,. \ L . (Phone) S~
APPLICANT SIGNATURE ~(l, \6.MSh--y~ DA~ ~, - d- 0 -- O~
APPLICANT t.{EASE COMPLETE BELOW
DNEW CONSTRUCTION ~ REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL Lvr\ '('\1)'(' G lo 0 U \-\ \J '~(o A - 070 FUEL N ad- ( CfC{S
FLUE SIZE RETURN OPENINGS INPUT 10, DuO OUTPUT leA, -b 00
TYPE OF SYSTEM REA TING OR POWER PLANT
OWarm Air Plants
o Gravity
o Mechanical
gjAir Conditioning L..e{l.1'Vt7)C
OVent. System liS'll 5- D~
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
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3<1. SO
~ .50
LfO I DO
(Office Lise Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
paid.LjO,O-V Recei0'9f;d
Daj /___ 3-;)- '1J CJ- ~y
~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
, , ciTY OF PRIOR LAKE
INSPECTION tiOTICE
DATE
TIME
SCHEDULED
/l
-~- .,.';
ADDRESS
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O!J/!f' L'/
OWNER
CONTR.
PHONE NO.
~) Ie 1-/
r - "~~ ,./
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
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
( <....
/
_I
L)CJ/
~1JL/
IZJ WORK SATISFACTORY, PROCEED
1 0 CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
/1,1'/) ')" , ' )
)/ ',' ~ I ~. ~,'},--.
Inspector: If. I - ,;-- ",' 'Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
'-
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BUHNSVILLE
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave S, Savage, MN 55378 · 952-894-0005
Orstat Test Report for JoW Lj(p( Z
Address (/71 <../1 ;Y) "'J /.,..", (' /, City P L /
Occupant :5 -1-... '-# ?~ A ,~_ ~ t"
. . c::'J
Date of Install 11/"2 .:; /0 1.. ~
Type of HT. F/A Y HW Space HT Unit HT
Other
Make '- ,., ^-/~(\ 1'.
Model ;;. &oullu - -;(A,A <(;>"'70
Serial 5 r;o ZY (/(;" rg:/c
Input 70~0
Pilot Type
Pressure
Input CFH
Stack Temp
HOT SURFACE IGNITOR
5 ~ S C02 (,".;.
//)/<J6cj 02 (,1
32 <' CO (J
Date Tested
/ ( '7 ( /,:
Company BURNSVILLE HEATING & AIR CONDITIONING
Technician /LJ ~
(