HomeMy WebLinkAboutMechanical 03-0817
~ CITY OF PRIOR LAKJ.:
INSPECTION NOTICE
SCHEDULED
ADDRESS
S'too Glarv ( f i'
(
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
r lj/Y1 lite
COMMENTS:
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DATE nME
7"'//
J"
J'"" 8'/7
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
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)
/
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---
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,- f
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,
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ':"~~~LL FOR REINSPECTION BEFORE COVERING
Inspector: V Vl/ 7, / /;([}Owner/Contr:
CALL 447-9850 FOR THE N~~T INl?PECTIQN ~4 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTl
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SEDGWICK HEATING & AIR CONDITIONING CO.
8910 WENTWORTH AVENUE SOUTH. MINNEAPOLIS, MN 55420 . (952) 881-9000
HEATING
TEST RECORD
JOB Nn 5 J Y ! 't
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CITY.
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OCCUPANT.
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INSTALLED BY _.::;~ U t
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SOLD BY
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SERIAL NO. 5;>i~/5 -;L.<:Cr?3
MODEL.
c; 60 u. H
J' 13- 0; 0
INPUT .f(5-~
THERMOSTAT
VAIV~/
L1MIT~:J- ""/
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VENT ~171=
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TYPE OF L1NI=P 6
LINER C:I71=
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LIMIT SETTINr,./~1"?
FAN SETTING~~~./
PILOT TYP~:~-+
IGNITION MODELC~kr-v'/
PILOT TIMIW" /h,tL-I
PRESSURF 3' <?
~ INPUT CFH Err ova
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~TACK TEMP-!I/,/ls()
F~M 235 (REV. 11/89)
FILTERS: SIZE. ;;;?(;J X-d S- Y 'I
WIRING~-'/~U~ ;f",
NUMBEP
PERCENT CO2 ff
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PERCENT O2 ./
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PERCENT cn
TEST TAG
LIGHTING INST-
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DATE TESTl=n <::;>~/r) <-
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COMPANY TESTING ..s-~L. ,/~ft
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NAME OF TESTER _-->/-::",_:::: k.
FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY _ CITY
CITY OF PRIOR LAKE
REA TING/ AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
f9. Ie;. Q3
I. Pink
2. Green
3. Yellow
~~~. I PERMIT NO.I"\? _ r-a..n
Applicant LL..:' l/U
(Please type or print and sign at bu."'~)
ADDRESS
~()IJ ~ r!vv.-a
I LEGAL DESCR.1.t'uON (office use only)
LOT 7 BLOCK / ADDITION /1M DV ~ 1.(' r
ZONING (office use)
R./
PIDZ5- /80- 007-0
OWNER
(Name)
db/m
~f~
L~..5
(Phone) ~(J - rJ J IP - ~'.s.J...
(Address)
APPLICANT
(Name)
~:-""
- ~":{ I~G a AIR CONDlTIC/....
S910 Wentworth Ave. So
M~~-poils. MN 00420
(952} 881-9000
(Contact Person) I (Phone)
- 'PPLICANTSIGNATUR~.A ~~. DATE t -11~
. .:;...- r r~
APPLICANT PLE SE COMPLETE BELOW
DNEW CON:ry.UCTION ffREPLACEMENT D AL TERA TIONS
FURNACEMAKEANDMODEL~ sI:f?puH -iIsJJ /)4&J FUEL ~
FLUE SIZE b ~l RETURN OPENINGS INPuTqP',t:?tlb O~PUT 71 ~~o
, .
HEATING OR POWER PLANT
(Phone)
(Address)
(City)
(Zip Code)
TYPE OF SYSTEM
~ann Air Plants
o Gravity
0Mechanical
DAir Conditioning
DVent. System
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
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Estimated Cost $..J ..s t/O .'"
Residential, Additions & Alterations
Residential, AC Only
Building Permit # O? - 08/7
~ ..,
$39.50. /
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
HEArING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
..i4.$b
. .50
LfA .J)~
jlice Use Only)
lis Application Becomes Your Building Permit When Approved
Building Official
Date
I paid4-(). 0 ()
D~ J1 03
Receipt 4ft- t, '3
By 1.
u
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
SEDGWICK HEATING & AIR CONDITIONING CO.
8910 WENTWoRTH AVENUE SOUTH · MINNEAPOLIS, MN 55420 . (952) 891-9000
I
ADDRESS 5'10~ G'o~ C":iv-c..1e..
OCCUPANT -A J~~ L e.'.u ~
SOLD BY - Q <> '"'-3 t}1Gtv::s h
MAKE _ L ~ '" '" 0 ><-
SERIAL NO. .2t;"?L5 ~.5yCt"];3
A-tl ~J6 J
THERMOSTAT
VAL~ ~
LIM/T~
LIMIT SETTINGLza.
FAN SETTING~~t.L
PILOT Typ~L2:7
IGNITION MODEL6~A.A/ ,,~./ _
PILOT TIMING c:...;~S;6A.-;
PRESSURE~ ______ PERCENTC02~
INPUT CFH - ~f'O _ PERCENT O2 ~
CJ
STACK TEMP.,/CfrL. PERCENT CO_
FORM 235 (REV. 11189)
-
/
-
-
HEATING
TEST RECORD
JOB NO
5JLj J>~
----
CITY.
Ario....
L 'l ke
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OWNER S t(~~"",-
INSTALLED BY ~~U ~ ,{' 4> -
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MODEL _
(; bO U H
J' {3- ace 0
INPUT~
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VENT SIZE ~
TYPE OF lINER~
LINER SIZE ~
FILTERS: S/ZE.Q?O -l-O<5" Y"'i.
W/RING~~..s:-~4
--
TESTTAG_
LIGHTING INST.-=:" ._
DATE TESTED_ '5~
COMPANY TESTING ~~./"V,/"~/' _
NAME OF TESTER -.5"'>fj ~ _
-
NUMBER
-
FORM DISTRIBUTION: WHITE COPY. JOB FilE
YELLOW copy. CITY