HomeMy WebLinkAboutMechanical Permit #01-0002
~
CITY OF PRIOR LAKE Me
16200 Eagle Creek Av. S.E. Permit No. f) 1- 00 OZ-
Prior Lake, MN 55372
Date
HEATING APPLICATION / PERMIT
I:; ';):;.00 PID # --Z.5 ..~O- 007- 0
, .
Site Address
6..5..6..6 ~ T ..ASG.O W 'r RAT T.
Lot
Block
Addition
Owner's Name VIRGINIA COSTELO
Address
2177 STANFORD AV
Heating Contractor RON I S MECHANICAL., INC.
Address
12010 OLD BRICK YARD RD ~~nwnp~~
Telephone # q C:;? /44 c:; - R c; R c;
Furnace Make & Model .A rrns-tr{) na
Model Size Gt I CA3 AU. () ~ '1TJf it ()
Conn. Load
Fuel NG
Flue Size
Supply Openings
Return Openings
Input (01, DOV Output (P'2 t 3 )0
Edr.
Cfm.
Anerations
TYPE OF WORK
Replacement ~
Repair
Est. Comp. Date
Est. Cost $
AIR CONDITIONER' UNITS CANNOT
ENCROACH INTO SIDEYARD SETBACKS.
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Other Devices
New Construction
11.1--1.t>D
01- 000'2
Building Permit #
~q . '3)
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
4t).oV Receipt # 36~
TYPE OF STRUCTURE
1. Pink - File
2. Green - City
3. Yellow - Contractor
Single Family
Commercial
~
,
Multi-Family
Other
Two-Family
Industrial
Public
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$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
case of all work which requires review and approval of plans.
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ol.tf--!f
DATE
CITY OF PRIDR LAKE
INSPECTION NOTICE
SCHEDULED ~/ /~ 701
/ / '
q:.p U460W -r;-
UCONTR.
ADDRESS ---.h 5/r; r;,
OWNER
PHONE NO.
(-Q :)
PERMIT NO.
TIME ~
///~
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULA TION ~ 0 SEWER HOOKUP.. ..... 0 FIREPLACE FINAL
o FINAL 0 PLUMBING FINAL ~ 0 GASLlNE AIR TST
o SITE INSPECTION )!( MECH FINAL · 0
COMMENTS: ~i1.~ ~~
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~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~l
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
MAKE
Model
Serial
INPUT _
Form 235
G-iASfrC~
VI .2C-1 ,Wi A
c. (~ S'J(FL. c.
HOUSE HEATING TEST RECORD
FLOOR.
GA
FA ).
HW
ADDR ESS ,
OCCUPANT.
HEAT LOSS _ DATE HTG. INST.
SOL 0 BY _ ~,c ,...,;:- "'\-1 eC IIA A.J: cA (
Electrical Worlc By
TYPE OF HEAT
GAS DESIGN
A (~...N? ST.~.. (' :.-k,
GI Dt)'JAUOCO"70J ~~ -lA
<rl ".00 l=? 0.{ <;9 t(\
~ '/ . ~... c. c,
CONTROLS
Heat Plug
pCl Y. i.~-t\
C
r~) (iT .
.. At i"r:::
c.; V("'~l'"iH ~
./
'-;?--.
Percent CO2
Percent O2
Percent CO
Q t
7. C.~..
Ct
STEAM
APT.
OWNER
INSTALLED BY t~{j vi
Gas Line By
_ SPACE HTR. UNIT HTR.
CITY
;p.L
SUBURB
........IIJi.:j...' D M ':II (
CONVERSION
,OTHER
MAKE OF BURNER
Model
Max. BTU Rating
MAKE OF FURNACE
Madel
Vent Size
..,. {'( F' '" C
THERMOSTAT _
Valve
limit
Limit Se"ing
Fan Setting
Pilot Type
Pi lot Make
Pilot Model
Pilot Timing
l. W. Cut Off
Pressure Cc;-f. 'S'" F' 5'
Input CFH-3., -,. S"C. (l
Stack Temp.. I o-~
1\/
A
'\
KIND OF LINER SIZF NONF
Draft Hood RegulaTor
Fi Iters Size ~ .~ ~.c; Number
)(
Chimney Location Inside _ Outside.
Chimney Construction ;' v' (:.
Wiring
\ / Te.t Tag )(
^.. Lighting Inst.
12 /"Z- z/~ {,
; :l.C ~,S .~1 t","C I.' ,}. ^" CI1 {
--:r"(~ <' #'--....:1 (,......(~ c. Nt:' ,..;.J
Smoke Bomb
Oraft .
Door Pressure
Date Tested
Company Testing
No..... of Tester.