HomeMy WebLinkAboutMech Permit 02-0344
4- 9-02; 7:29AM
6124474245;#
CITY OF PRIOR LAKE
ttliATINGJAIR CONDITIONINGJ ti1.KEPLACE PERl\rl11
Date Ree'd
I, Pink PUe u u..I'T NO I
~. Gr= Clly I I!".NUI. .. . /J'J ~ /.\ 3l J'I'
3. YeUow Appll;anl UO'fo U '/
(pleaSe we or print and sim at boanm)
ADDRESS
lo~,g 150"1+~, ~
ZONING (oflite use)
t, 5lJ
LEGAL DESCRIPTION (office use Duly)
LOT I BLOCK l ADDITION
p N.m..fh01~f;s+.I.t.,+~?5' /7S-0{)r 0,
~:i. )i V'A (1-<.._.. k..~'\l :?xu-Ii. -<- . (phone) ~5~ -440 ~..9f.3d:-
(Adcitess) lP ~1<6 1 ~ 8- ~ SG f ,,- ~ CJr b-~ke.. . <rY\'t}' ;::; j 6 1'6
,
~~~~~aJ.~~~ ~sL ~~~~~~~~,
~ (A~5S) (City) r IJ (Zip Code)
(Con""" Person) rY\ VO~o.et L -Q.. . (Phone) -nor If - 0:::D5
APPLIC~NTSIGNATURE "-J~l ~~ DATE l1--9-o~
APPLIC~T PL~ASE COMPLETE BELOW
. ONEW CONSTRUCTION ~LACEMENT 0 ALTERATIONS .
FURNACEMAKEANDMODEL L-~V\6{ G bda.ct1\/~=3L>B., D90 FUEL tJ-A-+-
- i .
FLUE SIZE RETIIRN OPENINGS . INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
. . OWarm Air Plants 0 Steam
D~~ O~W~
o Mechanical 0 Radiation
DAir Conditioning 0 Special Devices
OVent. System 0 Other Devices
PLEASE NOTE: .
Air Conditioner Units .
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Residential. Heating & AlC (New Construction)
Residential. Heating Only (New Construction)
FEE SCHEDULE
1 % of job cost Residential, GIlS Fircplll(;e
$39.50 minimum ......>.
$99.50 Residential, Additions & Alterations
$64.50 Residential. AC Only
$39.S0
Industrial, Commercial & Multi-Family
$39.50
$39.50
Estimated Cost $
Building pennit #
flEA TING PERMlT FEE
STATE SURCfiARGE
TOTAL PERMIT FEE
$
$
S
39',BC
.50
~(i.. c(J
BUilding omc:ial
Date::
....'~
. .....,.~:
Pa~ ij(? I OO.ReceiPt1ii~7Y
Daie/f_ /I-OY \ By ~
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Z4 h,our notice for all Inspections (951) 447-9850, fax (952) 447-4245
CITY OF--PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~ 2,7f3
/0 V 77f Sr.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING ~
o INSULATION
FINAL
;g SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING,iINAL
o MECH FI-'
\~f:'
COMMENTS:
(jo~~~_/
~
~fa.M- ·
DATE TIME
4f1q,,(t~ ZI3b
o Z- - 0341 -
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
..,.. -EtJumb
~ Ale-
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ I Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTl
- ....... ~
BURN~V.LLE
Heating & <Air Conditioning, L.L.c.
12481 Rhode 1sland Ave S, Savage, MN 55378.952-894-0005
Orstat Test Report for Job# ? ~ ('.'74
Address~). 7 8' I ~b. 57Sc- City P (I ~ r t. ('~ ~p
Occupant ~'~ tY"\ ~ l\ r k. e.. , --
Date of Install 4'" I 9~o~.
Type of HT. F/A ~ HW Space HT Unit HT
f
Other
Make
Model
Serial
Input
~ j/\ n <::) 'K
C. t; hLA \+ V 5 tc B ... 0 f Q
S<? \J~~ ! O~9> I
q() O~ ?)
. J
Pilot Type HOT SURFACE IGNITOR
Pressure -:l , S- CO2 U
Input CFH 02 6",
-
Stack Temp ? ::1< c CO 0
-
Date Tested L..J -- J '1 ~n~
Company BUJjNSVILLE HEATING & AIR CONDITIONING
Technician A'L~-
,. I;