HomeMy WebLinkAboutHeating 08-0306
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~ VR10 ./1-?c3J /J CITY OF PRIOR LAKE
:,..0 1~ HEATING/AIR CONDITIONING/FIREPLACE PERMIT
E-< '7'
.... ~
U t1'J
Date Rec'd
i ~~~onw 1~~iCan[ I PERMIT NO.OS. 030~
ZONING (office use)
ADDRESS
/5;2/5
0[..
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
~ +!(Fhkf;
[ OWNER
(Name)
(Address)
(Phone)
APPLICANT
(Name)
(Address)
S;:>:\' .. .... '. I,'''' A TING & llR CONO:TlmliNG LLC
8910 Wentv/orth A.V8.
MinXt~}S~8:~ 1~;~O~SL.20
(Phone)
(City)
(Zip Code)
(Contact Person)
(Phone)
DATE
APPLICANT SIGNA TV
APPLICANT PLEA E COMPLETE BELOW
DNEW CO~ION ;j;lEPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL( '41.# (/Jk#1!.1hlitJ10 FUEL ~
FLUE SIZE 0 II RETURN OPENINGS INPUT t ~ ~tJiJ ~PUT 7J /J/)/)
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
Fireplaces with Box Additions or
Cantilevers to the Outside of Buildings
Require a Building Permit.
Ij1Warm Air Plants
~Gravity
Mechanical
Air Conditioning
DVent. System
o Steam
D Hot Water
D Radiation
D Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$49.50 minimum
$149.50
$64.50
$49.50
Industrial, Commercial & Multi-Family
Residential, Additions & Alterations
Resideritliil,Ac Only
$49.50
$49.50
Estimated Cost $ L.J J k q /
Building Permit #
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
1./ Cf,J'o
.50
~1J.oO
,ftice Use Only)
This Application Becomes Your Building Permit When Approved
Date
Paid...)O. 0 0
Dat~ 30 Gs/
::;/. .
Rece'p No. 557 E:; I
Buildin!! Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
HEATING
TEST RECORD
bO&l L
SEDGWICK HEATING & AIR CONDITIONING CO.
8910 WENTWORTH AVENUE SOUTH 0 MINNEAPOLIS, MN 55420 0(952) 881-9000
ADDRESS
I(SJ.-l 5
r:J '
F~ 5 ~ I' lO.'~~
r t r'i!'
OCCUPANT
SOLDBY ~")e C( 3L0' C(
MAKE k ~ ,---.).--..,1 Cl--P
SERIAL NO. 59 Df5nZZS-S-i
THERMOSTAT "-J [~ [fCUJ
VALVE ~Cl ~.u
LIMIT -t__
LIMIT SETTING n 0
FAN SETTING '77JYy! I d
PILOT TYPE cil/YI. ~ '{Y:!{~
IGNITION MODEL H,S 'T.. .
PILOT TIMING 5-'ie.L ,
,., 511/1.... (JJ c..
PRESSURE.:5 · 't) \ PERCENT CO2
INPUT CFH Be, PERCENT O2
STACK TEMP. ~z;-- PERCENT CO
BOb
" t> IE.">
,--0
FORM 235 (REV 11/89)
JOB NO.
CITY ff'J1'1 (j.^- LV1k ~
OWNER 1? 6~ e ,.f- N () 4- v'.e {-
INSTALLED BY Z1 d~j((L
MODEL 0 UH'-.j :3 G
. (}to
INPUT
l\
VENT SIZE
TYPE OF L1NER.:=B - L.uIrcf-
. II
LINER SIZE {Q
FILTERS: SIZE '} 10"6
WIRING ~-p th d7i( CO
NUMBER -'
TEST TAG -
LIGHTING INST. -
DATE TESTED ':)/22./08
COMPANY TESTING ~Id
NAME OF TESTER g_ _ 0
FORM DISTRIBUTION: WHITE COPY. JOB FILE YELLOW COPY. CITY