HomeMy WebLinkAboutMech Permit 02-0287
CITY OF PRIOR LAKE
l1EA TING/ AIR CONDITIONING/FIREPLACE PERMIT
..
(Please type or print and si$tD. at :'u~;"~l)
ADDRESS
\ l\ ~ -, '1 S\\n rllj t'k ~ C7\ Q.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK ADDITION
OWNER
(Name)
030 b j/p { & A./i
- J
(Address)
APPLICANT0 ~. \ (J "" ---
(Name) '.~ N {\ ~'\ \ ~ '-r-\"'~1.t. X:)..'~1
(Address) 12LJjl /lLhDcU Is {lj')& ~ S"-
(Address)
(Contact Person)
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W{~~;J~.
APPLICANT SIGNATURE
....
Date Rec'd
3- 2- 6-02-
~. ~:n ~:~, I PERMIT NO. OZ......... 0'7 CJ..1
3. Yellow Apphcant vV
. zoNING (office use)
PID 25 -04-5- OtJ7 - ()
,
(Phone) 95":2-LlY..5-~b31
(Phone) 95 {). r )/9 i.{ ~oooS-
_<)() A )~. Q. 5S37~
(City) t' (Zip Code)
(Phone)
DATE
. q-;;{S--O:;J-
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION IE. REPLACEMENT 0 AL TERA TIONS ,
FURNACE MAKE AND MODEL ~nri)( ~ &'0 Ll k V 7>(oJ)n qO FUEL f-.-Cd:. ltas
FLUE SIZE RETURN OPENINGS INPUT 1DI ()OO OUTPUT
TYPE OF SYSTEM REA TING OR POWER PLANT
~arm Air Plants 0 Steam
OGravity 0 Hot Water
o Mechanical 0 Radiation
OAir Conditioning 0 Special Devices
OVent. System 0 Other Devices
FIREPLACE MAKE AND MODEL
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
$39.50
Building Permit # 0 Z ,0 Z-tJ
$. 39. 5-0
$ .50
$ @.OO
Estimated Cost $ 5000.00
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Appli~~if~ ~eypmes y ou~uilding Permit When Approved
la'fl~ $-2-8-02-
Building Official Date
Paid +0. dO
Date
3-U; .-02--
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
I Recei~~4-l5 4-'
BY~
;
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULiiO
DATE
TIME
~-18-0Z- .3; crV
ADDRESS
.-
/1fI'z, 7 7 sfh9t;:; <./ 8~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)l)FINAL
(0- SITE INSPECTION
COMMENTS:
-ILl - ~
~'2-- ~
,
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~4
-
~ ~ oIfC/
~V
~z--oZ87
,
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~G~~~
(2..)
v/
V
'tWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ " Owner/Contr:
CALL 447-9850~OR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
J '9
~,...,~.., .-
...
.1 ..
BIJRZVSVILLE
.
Heating & Air Conditioning, L.L.c.
12481 Rhode Island Ave S, Savage, MN 55378.952-894-0005
O. ,)IaL Test Report for JoW S '$ l~
Address ^"/L(l71 S~~1"'t City
Occupant K".I ( ....;
~ - . , ,
Date of Install 4..( - , ? -0 ~
Type of HT. F/A XJ HW Space HT Unit HT
Other
Make J....~ t\" (J~
ol'~ Model c: ~OI..l.H.Y-< 6R - O"CL..
Serial S~O ~ e \0 ~ ~~ .
Input ~ () , (i') 0 C
Pilot Type HOT SURFACE IGNITOR
Pressure 1. <;- C02 ". 2.
InputCFH - 02 7 . ~
Stack Temp ~ co t:J
Date Tested
Company
Technician
"'-"7
BURNSVILLE HEATING & AIR CONDITIONING
fl (' h.
~
. ,
01"'.. ~
,..
#
BVRNSVILLE
# .
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave S, Savage, MN 55378.952-894-0005
O. ~IaL Test Report for JoW 5. ~ '\' ~
Address 1'1~ 77 ShO\~~ ~~\'c~ <Pr\C)( ~~j
Occupant K ~ \ \-e "to I
Date of Install t" I - C1 - d:L
Type of HT. F/A ~ HW Space HT Unit HT
Other
Make L. ~ '^~a)O
Model ... for) ~+t- V -3 6 ~ ~ 0
Serial 5"'<6o;lJ<? 1 0 <;?~ S-
-
Input or ~I CJCj r J
HOT SURFACE IGNITOR
(,S- C02 q
... 02 7
"1 J ~ co c/
/ ~J'~-cQ.
, ~.
BURNSVILLE HEATING & AIR CONDITIONING
Pilot Type
Pressure
Input CFH
Stack Temp
Date Tested r:? \ c;I'l
Company
Technician