HomeMy WebLinkAboutMech Permit 05-0012
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CITY OF PRIOR LAKE
REA TING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
at bottom)
~.~~~:v Jl~icanl I PERMIT NO. 05-00/1.;L-
\JI~
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCI--I ADDITION
OWNER G
(Name) or E (;
~
:sf PID
I~E' \
ZONING (office
use)
o
(Phone) q5d - WLI D " (oO~ to
(Address) I I 1"3L.J
APPLICANT C
(Name)c:> r"\ + (' D J J 60
AIr
(Phone) /05/ - t..4lo0- (ooa ex
(Phone) 1.05 \ - 3L..\l..\ -l-\Q)5"3
DATE I e;- aq - oLj
PLEAS COMPLETE BELOW
DNEW CONSTRUCTION ~EPLACEMENT 0 AL TERA TlONS
FURNACEMAKEANDMODEL \rAr)t 'J...,LeO FUEL ~C:s
FLUE SIZE RETURN OPENINGS INPUT 60. OCX:::; OUTPUT (oLj. 000
TYPE OF SYSTEM HEATING OR POWER PLANT
(Address)
~ \ & I 0 EPl'-h,,,, A '.f E;
(Address)
(Contact Person) L I .., d ~
F 6Tr0
(City)
APPLICANT SIGNATURE
DWarm Air Plants
DGravity
D Mechanical
r2rAir Conditioning
DVent. System
D Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $ L4 \ ~ . q It;>
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$ 3Q.50
$ .50
$ YO.no
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid l/(), __
Dati_ 3- ~
BuiIdinl! Offieial
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
550aL..\
(Zip Code)
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Recei,pt No. LJ
(.. go ij'
By
. ~,: PRIOR LAKE
INSPECTION NOTICE
~ATE TIME
SCHEDULED ~--
WdJdclv<!'e~ cl-
ADDRESS
/?/;j'y
.
OWNER
CONTR.
PERMIT NO.
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
c~, MENT~: {
p,/JMC-t.J
/ J
/..e. c -<'- / J< d
;
&~6~~~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
.....P-MECH FINAL
as--/2
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
--- ~/
rUYJ/ltTC e r. '/ e:
c?rs-t f-- 7;,.r~
A/r
/0
/
't
~;~::::=: ~/ C--
o CORRECT WORK A OR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr.
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOT/
HOUSE HEATING TEST !RECORD [}~M'/ J"
ADDRESS /7/3cj (A. f) ooJ (lIt \,.> (-I..s. E. APT. _FLOOR _CITY~~6aURB
OCCUPANT OWNER
HEAT LOSS ~ Q~TEtttTGJ\INST.
SOLD BY t.. is\ Yl +rt. (11. ~ ~ I r INSTALLED BY CONTROLLED AIR
EI.ctrical Work By Gaa Lin. By CONTROLLEtL~
TYPE OF HEAT GA _ FA--- HW _STEAM _SPACE HTR. _UNIT HTR. _OTHER
~r~ ~s~~
MAKE , ,'-.
~~~ cit;.. \f;,~~
CONVERSION
MAKE OF BURNER
Modal
Ma.. BTU Rating
MAKE OF FURNACE
Mad.1
Vant Size 6 U 0"\ t--
KIND OF LINER SIZE
Draft Hood RGtulalOr
Filta,. Si:r.l~(~K{ ~r
Ollmnay Location 7!da
Olimnay Conatruction ' t / Pvt-t"'
CONTROLS
H.at PI",
~
NONE
Outaid.
t{f\..2'<>
Smok. Bomb Wlrln,
Draft T.at Ta,
Door Pr...ur. Llghtln, Inat.
p.rc.ntC02~ Data T.atecl) <<: <;
Parc.nt O2 Company T.ating C~TROLLED AIR
P.reant CO Na_ of T.at.r b.........
Pr..aur.
Input CFH
Stack T.mp.
Form 235