HomeMy WebLinkAboutMech Permit 02-0212
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
I. Pink
2. Green
3. Yellow
Fite
City
Applicant
(Please type or print and silm at bottom)
ADDRESS
14424 WATERSEDGE TRAIL
LEGAL DESCRLt'uON (office use only)
LOT:J~ BLOCK ADDITION (30 L-Ld ; IJ 5 IJIlIl rvO Ir
OWNER
(Name)
Date Rec'd
PIDa.s-- //1- Od.o.-D
JOHN VIG JR.
(Phone) 952-440-1674
(Address)
14424 WATERSEDGE TRAIL
APPLICANT
(Name) RON I S MECHANICAL, INC.
(Address)
12010 OLD BRICK YARD RD
(Address)
SHAKOPEE
(Phone) 952 - 4 4 5 - 8 58 5
MN
55379
(Zip Code)
(Contact Person)
APPLICANT SIGNATURE r5h~4tv~
\I
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION j2g REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL Unnb)t G3003"~S FUEL #6
FLUE SIZE RETURN OPENINGS INPUT -.1'5. noD OUTPUT
(City)
(Phone)
DATE
TYPE OF SYSTEM
DWarm Air Plants
o Gravity
1SJvtechanical
DAir Conditioning
DVent. System
REA TING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
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
Residential, Heating & A/C (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3q.~
LiD.ou .sO
(Office Use Only)
This Application Becomes Your Building Permit When Approved
paid~ Lf IJ/OO
Date 8-~-o~
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
3"8'cnr
. {o9 J OtJD
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
ReceiPZi 01 :5 /
By .
B-U
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/Lj~,;)L(
SCHEDULED !J{ L Vb z, U 't ~ 0
0~e~~
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o Z- - 'l... I Z-
o FOOTING
o FOUNDATION
o FRAMING (f)
o INSULATION
FINAL
~ SITE INSPECTIO
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: ~ .
~
-
~
~~
;af WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspeolo" ~, OwnerlCont"
CALL 447~~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSIIOTl
,. I , , . H. OUSE HEATING TEST
J L/ '-t ,,~ LV~~S::.~ ~ _APT.
dnVl. "" \J\..~ tJ '" I '-J ~ .OWNER
.DATE1rtG. INST. '"3 - ~- ~..
RECORD
SUBURB ~('~lJ\ Lt~~
ADDRESS
OCCUPANT
HEAT LOSS_
SOLD BY
Electrical Work By
TYPE OF HEAT
FLOOR
.CITY
~(')'" \ ~
.INSTALLED BY
. Ga. Line By
SPACE HTR.
GA
FA
_HW
_STEAM
.UNIT HTR.
OTHER _
~ GAS DESIGN
MAK E ~...........O )( _
Model~'^m.'..s- ./~- ~
Serial C>~ '3 ~ \ ~~~. I
INPUT !:::> ~ ~('i~
f
CONVERSION
MAKE OF BURNER
Model
Max. BTU Rating
MAKE OF FURNACE
Model
----- .--
~ (
./ ----
-----. .
r-7 r {)...... \J ,C ;A. "-----
Heat Plug _ Vent Sin J . D _'i '-...'-', ""
~ _ KIN 0 OF LINE R .J.:6...- \lo_SK::,~,ze-:::::
- \ _ Draft Hood _ R.fgula,or
\ "'t ~ - Filters Size.Le.~~f.Number
H ~ ~ "__ ~ChimneY Location In.)..(!e. 't <. '~ut.ide --...
. \ ~ \ I imney Con.truction ~ \J ~ \f'\....
~ \ ./v\, -. ---
-'
CONTROLS
THERMOSTAT
........
.NONF
Valve
Limit.
Limit Setting
Fan Setting
Pilot Type
Pilot Make
Pilot Model
Pilot Timing.
L. W. Cut Off
Pressure 3.';;;--' Percent co
Input CFH 'is- ~j Percent 02
Stack Temp. _ "0 ~ Percent CO"
_ Smoke Bomb
_ Draft .
Door Pre..ure
~ _W~-
~
_ ------ Lighting I~
g-~(s..:r- ~~.
~~~
Lt,L\
;3. \
~
_ Date Te.ted
_ Company Te.ting
_ Name of Te.ter .
F olm 235