HomeMy WebLinkAboutMechanical 03-0729
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
t.l :Z-~7.
-- ..
j'1/(,}p .~~ Ave.
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~ - 72-Cz
COMMENTS:
o PLUMBING RI 0 EXIGRADIFILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
)if MECH FINAL 0 ~
A/C- ~ ~~ ~/Iv!7~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
.
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
'''POdO<' ~ Owoe"Cont,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
T-
SEDGWICK HEATING & AIR CONDITIONING CO.
8910 WENTWORTH AVENUE SOUTH' MINNEAPOLIS, MN 55420 . (952) 881-9000
ADDRESS
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OCCUPANT
SOLD BY
....-
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C/..'-tLo
MAKF
!CNNvV
~ <6 0 _'$l~~ ?~'-I-) ~
SERIAL NO.
THERMOSTAT T/?-C 0 (/
{J / . ~.""L- tfn~j
(, / /
-I J (r
LIMIT SETTINr:: < )"j/J"r=' .
.r c VLJ
VALVE
LIMIT
FAN SETTING
PILOT TYpl=
r) rOL-P'
/,&r
IGNITION MODEl
PILOT TIMING S- ~ P / f'J1r ~ /~
PRESSURE 3 c:::; ('J..C . PERCENT CO-
INPUT CFH qo PERCENT O2 ..
STACK TEM)~7 PERCENT CO
FORM 235 (REV. 11/89)
,
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01%
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"
HEATING
TEST RECORD
CITY
/Q/UY!l4k..c.
OWNER .-s"-p4 m e..
INSTALLED BY IJ t::I " k
MODEL
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INPUT
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(IT
LINER SIZF 0
FILTERS; SIZE ...s::..)CJl.J<:::; 'I '-I
VENT SI71=
TYPE OF IdNER
WIRING
TEST TAG
LIGHTING INST. -
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DATE TESTE ["I
COMPANY TESTING
NAME OF TESTER
"'*_"--:'J'\'~,~' ,~
NUMBER
JOB NO. 5 3 11.,;"';2., - fI\
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..
FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY - CITY
~. .~~ .....~ ...~.-.- ....~.
CIT~ OF 'PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~e~n ~:~y I PERMIT NO.?l3 .-J1'"\t17
3. Yellow Applicant f/ - 1M
,Please type or print and siq;n at bottom)
ADDRESS
/J.//~~ ~n /).1)
lJe
ZONING (office use)
fJ /151J
LEGAL DESCRIPTION (office use only) ..
LOT lBLOCK 8 ADDlTIO~ (J~" eX AJd
PIDdS ~tJs'()c;..{,-d
OWNER
(Name)
/h ,t'JIf1 LI j
~~.
CJ..p_J /11)
. (Phone) q5d. - J J ~ ,. ..5i2S..1
, (Address)
APPLICANT
(Name)
~--. ,! ~.- .~. ~~?,:!G & AHl r'.~~,;r 'Tr ~~"
(Phone)
L~ " _:: \ " :~1t'JJC(:11 .J
(Address) (Ad~~(~~~"~~~~~Q"O"':"O (City) (Zip Code)
(Contact Person) ~ (Phone)
APPLICANTSIGNATUR~40 ~ :d#~~ DATE ~-.1-,~J
APPLICANT PLEA COMPLETE BELOW
" DNEW CONS)RUCTION \3'REPLACEMENT 0 AL TERA TIONS
FURNACEMAKEANDMODEIO(~ "t/ ~bl./.#1/ Jde8LJt;o FUEL ~
FLUE SIZE h U RETURN OPENINGS INPUT q~~~/) OtHPUT Z1..rJ&CJ
TYPE OF SYSTEM REA TING OR POWER PLANT
0Warm Air Plants
DGravity
~Mechanical
~ir Conditioning
~ OVent. System
-F YLACE MAKE AND MODEL ~~
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
HSi. A I f -~JtP
oJ ~ ~t?n
Residential, Heating & AlC (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
$39.50
$39.50
Industrial, Commercial & Multi-Family
Estimated Cost $ ,fa~'"
Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
J f..5/J
.50
~~t1
11)ffice Use Only)
Building Official
Date
Paid tla,..--'
Date ~_ h~
ReceLi~6 77
By ~
(J
:his Application Becomes Your Building Permit When Approved
24 bour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
>T
SEDGWICK HEATING & AIR CONDITIONING CO.
8910 WENTWORTH AVENUE SOUTH. MINNEAPOLIS, MN 55420 . (952) 881-9000
ADDRESS -191,b~ _~.~ :1I~e ~E'.
OCCUPANT /J'J1G1.6..l ~ rI~G";-OY"~ C ''riJ.Lt;I
SOLD BY .,IlJ/k~ IJ?~N~"'"J
MAKE
4e.NN~
~ ~ 173F -_"?/;Jl.)!.j S-
SERIAL NO.
THERMOSTAT TU OeJ
j) ~1-L, fJ ('"l~
LIMIT ..fi .~ /Jr / .. (}11fJ
LIMIT SETTING~/J"r _
FAN SETTING ~ . 4If I
.Jl).J
VALVE
btOt.-/?
IGNITION MODEL IEr '
PILOT TIMING S 5'!! /' ~
PRESSURE .J. S I<d....( . _ PERCENT CO2
INPUTCFH '10 " PERCENTO.
STACK TEM)~t7' . PERCENT C~
PILOT TYPE
~%
~/%
o .f--._-
FORM 235 (REV. 11/89)
HEATING
TEST RECORD
JOB NO. S 3l./'f .:2...
CITY -,f? to -I" L M k .c-
v
OWNER J-I'IJ11<.-
INSTALLED BY --'l..a.,." k
MODEL J.('ou"lv - 3-GJJ- 09eJ
INPUT qOOOQ
I I If
VENT sm: L-j
TYPE OF LINER ~ c-.-I-
LINER SIZE 0 r
FILTERS: SIZE ':-)(')^d~'f. L{ NUMBER I===1ffi
r I v
WIRING
TEST TAG
LIGHTING INST. _' -_
DATE TESTED 6,/cr /c; <
~I -
COMPANY TESTING ~ ',i
NAME OF TESTER ---fh;.. ~~~
FORM DISTRIBJJTION: WHITE COpy - JOB FILE YELLOW COpy _ CITY