HomeMy WebLinkAboutMech Permit 02-0240
CITY OF PRIOR LAKE "-
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
3-/4-02-
~. ~e~ ~:~ PERMIT NOo'()Z'" A ?A/1
3, Yellow Applicant C/~v
(Please type or print and si~ at b~~;..~)
, ADDRESS
S <3 3 (p \ YY\'\f\n
LEGAL DESCRlJ:'uON (office use only)
~\~e.
s.
t:.
. ZONING (office use)
,e../ SD
LOT 9 BLOCK 2 ADDITION Or/I:'- Ife{OIEG (!;( /sr A:O.oAJ.
PID 2.5-0 B3 -034- .- ()
Ovv.NER Ii
(Name)~fl~ +.flleotf
(Address)
(Phone) q'i).l~4 4,- d.C}a,
APPLICANT <'"\2 I ~ I .' \ ~ L- - _\ - v:\ \
(Name) ~ _"'Jl_f\~ v\ U (l M Qf).1. J.. ] ~ c..
(Address) \ ~ l\g \ ~f) rO 0 _ \ ~ \@ -PlJe..S,
(Address)
(Phone) .-!l!3a- ~ 4 -oOf)<:;;;
Scu.JQaO- 6D37~
(City) r (Zip Code)
(Contact Person)
WUrel~
(Phone)
DATE
~ -/3-C) 'J-
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
. DNEW CONSTRUCTION. ~ REPLACEMENT 0 AL TERA TIONS
'\ . ~~ / LA.r1'1O)( j / . ,
I ~j~)FURNACE MAKE AND MODEL -L;(;D{JHVO~()70 , 0:l7m~O FUEL fia:f, fq12<..
\: FLUE SIZE RETURN OPENINGS INPUT 7:>J{)6D / UO/~OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants
DGravity
OjAechanical
0"Air Conditioning
DVent. 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
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 $ (olJOO.,OO
Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ ,?9. ~--o
$ .50
$ L/O .00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
rP)J$-- 3-14--0L
Building Official Date
Paid A ^ 0
~.-O
Date
3 -14--0L
ReceiP~iSO (p
By 4<<
;/
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
5"8'Jc
f7'
hd~u/\
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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2 - '':::tP'V1f1(-e-/?r
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DATE
T1"~ '~'.,
'$:j..::;~-:".:q.
. ~,
'3-U-
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
UJJ
"---'
}TWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: /h? ~-l f v{) IOwner/contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!
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Heating & Air Conditioning, L.L.C.
12481 Rhode 1s1and Ave S, Savage, MN 55378 · 952-894-0005
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O. ~lal Test Report for Jobl_ ?<;2 '-;f
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OccUpantt:" Ylj! tJ eo.. -.Q r
Dam of Ins1al1' :3. !.. ::>)":"'0 :l
Type of HT. FlA )0 HW Space HT Unit HT
Other
Make t- ~ V\ ....'\(') V
Model 0,0 U1fJl n~~7"
Serial Slit (); /J., ;La U'-'f.
Input 7()/~G
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Pilot Type
Pressure
Input CFH
\S1ack Temp
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HO.T SURFACE IGNITOR
~.~ C02 'f~
02 1. t;'
11<i' CO ...r)-
Date Tested
Company
Technician
?-?_cr-O?
BURNSVILLE HEATING & AIR CONDITIONING
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BURN~"~~~fi;-
Heating & AirConditioning, L.L.C.
12481 Rhode 1sland Ave S, Savage, MN 55378. 952-894-0005
01,,',," Test Report for Jobl ?<). "-;f
-
Address-5 r ~, J rv) ."'.lI", .? ~~ity/-f4 I c)~ .~ k
Occupant~ ~\" JQ; -.(l r '
Da1e of Install' :3.. - ::J)' -0 ). ,...~-...
Type of HT. F/A )0 HW ' Space HT Unit HT
Other
1
Make /- ~ ~'YV)V
Model "0 lJ..H.JL()~70
Serial ~ ()j..J;., )~:1 UJ>6
Input 7 () ;' C'.7] G
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Pilot Type _ HOT SURFACE IGNITOR
Pressure ?,. '<:- C02 ([. ~
Input CFH 02 1 - ~
~tackTemp ~ I~ CO ,r)-
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I
Date Tested
Company
Technician
?-?_\-02
BURNSVILLE HEATING & AIR CONDITIONING
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BUftN~"ILLE
Heating & Ai~r:onditioning, L.L.C.
12481 Rhode 1sland Ave S, Savage, MN 55378. 952-894-0005
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Ors1at Test Report for Jobl
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Address . ~ 5 I., j.Yrt , ~ .cUck..Q City
Occupant r tt t l..aq ... ~ -
Date of Ins13l1 ~ :..:>~ -0 ~..~
Type of HT. F/LXJ HW Space HT
Other
Unit HT
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Make t e \1\ y.. <i'\f
Model .t:...:) 7/J? If. r J
Serial _t~ \Do.) i ~ t
Input {>... I~ f'1
Pilot Type HOT SURFACE IGNITOR
Pressure 'S.!..5 C02
Input CFH 02
S1aCkTemp '~:.J I CO
Q.2
,
{'.7
'0,
Date Tested
Company
Technician
3' r)S:- 00-
BJjRNSVILLE HEATING & AIR CONDITIONING
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