HomeMy WebLinkAboutMech Permit 02-0511
05/07/02 TUE 15:00 FAX 6124474245
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CITY OF PRIOR LAKE \ 0)\9>
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
CITY OF PRIOR LAKE
III 001
D~te Rec' d
-'
cf5 -10 ':-")-
~'e~~:.u ~l~IOMt I PERMIT NOt)). -5"-/ / J
(Please tVDe or tlrint and sil!Jl at bottom)
ADDRESS '
ILf 3& I Sh 0 ve.- J-An--l N..t.
ZONING (office use)
{J /J5fJ
I
LEGAL DESCRIPTION (office use only)
LOT IJ BLOCK It? ADDITIO~d fJ r Lj~
(Address)
~ r ( s tfVLe {l (rLl.1 i
- I
143 (P ISh Wi. Lct.-Ytl.
PID..15- d/5'- oqo...-q
q 52. --tff./~ -{)II 5/
OWNER
(Name)
(Phone)
I1J.i
APPLICANT
(Name)
(Address)
~, AINJ: a.rrn A'~ ~I ~r.T I if\'r.
13562 CENTRAL AVE. N.E.
ANOKA, MN 55304
(Address)
(Phone) '1 U 3--757 .-{flUJv
(City)
(Zip Code)
(Contact Person)
(Phone)
~tt LfLLllhQJvLV1 DATE
.cr - 7 -() ;;;.-
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTtOl'j '~REPLACEMENT 0 AL TERA TrONS
FURNACE MAKE AND MODEL P-CUAO lA.Q, P L 0 I ftjIQ. K-Q.. FUEL lJ. ~ .
FLUE SIZE RETURN OPENINGS INPUT 'l 5,IS75D OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWe.rm Air Plants
OGrllvity
~Mechanical .
LlA.ir Conditioning
OVent. 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
Industrial. Commercial &. Multi-Family
FEE SCHEDULE
1% ot'job ccst Residel\tial. Gas Fireplace
$39,50 minimum
$99.50 Residential. Additions & Altcr.l.tions
$6450 Residential. AC Only
$39.50
R.esidential. Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estima.ted Cost $ 1..1) IJO .CJ{) Building Pennit #_
HEATING PERMiT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$.
$
$
3V;. s;o
.50
L/ () . ("J()
(Office Uee Only)
This Application Becomes Your Building Permit When Approved
Bujldin~ Offitial
DlUe
-
Paid. cP I Receipl;No. 7'\
J-/ b , . ./.I .;z C> ~ (...I
Dat~"ID_MBY Gt.----
V
24 hour notice for all inspections (952) 447-9850, Cu (952) 447-4245
ADDRESS
/.L(.3~ I
DATE TIME
SCHEDULED CI,fJ1~z..' J\...n
~.~
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
02- ~ '5"//
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)lZCFINAL
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:
()/~
,.
~
"~WORK SATISFACTORY, PROCEED
] CORRECT ACTION AND PROCEED
o CORRECT ~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: - ~ . Owner/Contr:
- J
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
BJ."NE
HEATING
AIR CONDITIONING
AND ELECTRIC, INC.
1\0 \ \ HOUSE
\)1/ \J
HEATING TEST RECORD
ADtflESS Ift~ tll I ~ ~N t LA
OCCUPANT/!'Jtll"i~+;t.V. -AJ Pi 1/
HEATLOSS DATE HTG.INST. '1- 1'-6 L-
SOlDBypht\)\"fAt,~ 0
Electrical Work By 1!114~l'l tt-h~ 1':\(<-
TYPE OF HEAT GA 0 oFA-L ~W _ STEA~ SPACE HTR
MAKE Rvva
Model V (,. PI... ~1f fJ E &( ~
Serial FLhl> <Jun. ~ t)~ 01. 1971 D?
INPUT 14 hO 0 .
I
THERMOSTATr-...t6li"'W1l1
ValU~. I~ lloiJr r,
Limi .
Limit Settinll i b
Fan Settilll/ -1-"1. ~
Pilot Type.J')'~IIt:-&-~D....vt
Pilot Make t-lV ·
Pilot Mode~ Iv 4
Pilot Timing 10 'JtL
L.W.CutOff
Presaurl.' ?"
Input CFH.
Stack Temp. 11 7
CITY:rr\O"~~{SUBURB
APT.
OWNER
INSTALLED BY 15 (~\W ~ Gl ~ l <C
Gas Line By _ i? , "\1.c. ~ L-~ \ l;\ e (..
UNIT HTR. OTHER
FLOOR
GAS DESIGN
CONVERSION
Vent Size
"I"
CONTROLS
Heat Plug"
KIND OF LINER
DraftHood T ~
Filters Size 2- ~ )l: (
Chimney Location Insidp )(.
Chimney Construction c... "" s "> is
NONE )(
SIZE
Regulator
Number
Outside
~z-5
I
Smoke Bomb _ Wiring "
Draft . Test Tag ><
Door Pressure " Lighting Inst. K"
DateTested 'f- &;-.v"1- ' _ _.
companYTe~ting . (~~ L1 cl ~
Name of Tester J.....::: C-'-/......:-.
c,;
Percent CO2_ b
Percent O2 #'(
Percent CO I)
Pressure.
Input CFH
Stack Temp._
" Percent CO2
Percent O2
. Percent CO