HomeMy WebLinkAboutMechanical Permit 01-0132
CITY OF PRIOR LAKE Me
16200 Eagle Cre~k Av. S.E. Permit No. 01- 0/32-
Prior L&ke, MN 55372
Date
PID#2!5--075- ODZ-O
\SO~ S~ 8. E.
Site Address
Lot Block Addition
Owner's Name \Jlcu- 0. 0-\ e..-*' ~-kf'\ 'Z-
Address 5<1laS \~ah. ~\- s-. E
Heating Contractor ~~ \ l.sL \-l Qa..h Y\(A ~l c
J:LLf~J thcdLr<. tslCU1d-c)~ - S; .
90-;z- ~Lf-CJOCFO
Address
Telephone #
Furnace Make & Model ~C\.n+- AIR CONDITIONER' UNITS CANNOT
. ?3'?:> B~~ 4~ osc ENCROACH INTO SIDEYARD SETBACKS.
Model Size
Conn. Load
5ro I (X) 0
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Other Devices
Fuel /'JcJ- [--r~~) Flue Size
Supply Openings
Return Openings
Input ffi 000
,
Output
Edr.
Cfm.
TYPE OF WORK
Alterations
Replacement X
New Construction
Repair Est. Comp. Date
Est. Cost $ Building Permit #
HEATING PERMIT FEE $ ~.$(..5V
STATE SURCHARGE $ .50
TOTAL PERMIT FEES $ ~ Receipt #
4fj.()O
39055
TYPE OF STRUCTU~r::
1. Pink File
2. Green - City
3. Yellow - Contractor
Single Family
Commercial
)<
. Two-Family
Industrial Public
Multi-Family .
Other
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
(" Residential, Additions & Aiterati;s
F1~:>lut:JlllIi::ll, Pt.\;' unlY
1 % of job cost ($39.50 minimum)
$99.50
.... ................
c--$04.5U --=>
$39.50
$39.50 ~
$39.50
Remember to add the State Surcharge on the bottom of this application.
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections will be billed at $35.00 each.
House Heating Test Record must be submitted with building permit number before build-
ing certificate of occupancy will be issued.
HEAT CALCULATIONS REQUIRED with number of supply and return openings listed per
room with CFM's per opening. New structures or additions send floor plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Phone: (952) 447-9850
Fax: (952) 447-4245
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
cas~;~ review and approval of Pla;.;;( ~ -0 I
- l .., Applic,^~~.ature Date
3./-01
Date
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDYL.IiP
3!a 1,/0 f
9.i5~
ADDRESS 5 9 ~ / ~ lJ.L ,J!!-.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o / - /3 Z
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION ,0,\) 0 SEWER HOOKUP
~ FINAL '(eJ 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS:~~~
Y'~' .-' -. ..t.~':"C~. ----:1 _1 t7-.-....::::~..."-' -.....
-~," {")ljI-(UL T~ -~ ..~
'.""~,_.,,,,,,..,,,..~ ..- .... . ...".,.:......
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~(~
IL
!' WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
CG..~ I
I nspector: ~ . Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
,........'..., ..-'- "',*,."'---..-"~' -- --- -
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'~",:,':C''1-;. ;,.'!~~}4;,~~,
BVRN~ILLE
Heating & Air Conditioning, Inc.,
12481 Rhode Island Ave. So., Savage. MN 55378 · 894-oolt5
Ors1at Test Report for JoW I 721
Address 57fp.:5 /:x>-III ..Sf 3"t-u City PI ;'0/ 1-,.9*<"
Occupant f'rj4r9~/ c:1- ,.;.. It. (.!f H G II j~ ~ 4vii;.
Date of Install 2- 27 - 01
Type of HT. F/A X HW Space HT LJilitHT
Other
Make B/~ /If) /J f
Model 33..? t8~v o<;<{ ogZJ
Serial I.; Il:f) R h& /55
Input 10 I 1f;D
Pilot Type J/o'-ISu' t"'.4cc
Pressure 3. _S
Input CFH eo
Stack Temp 3;2 (0
C02 <[. _5
02 Iv. 5
CO ()
. DateTested 2 - 27-tJ!
Company B 1)1 A.J$ <J j It 1./0";. '.1, ~ "I. /-
Name of Tester .PJJ
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