HomeMy WebLinkAboutMechanical 99-1065
" CITY OF PRIOR LAKE MC () -
18200 Eagle CreekAv. S.E. PIIIIl1MNo. qq-/()~
Prior Lake, MN 55372
HEATING APPUCATlON I PERMIT
9/-vT/t;"i PD' 2.S-lif./-OO"t-3
, -
7/ q:J /?~"'7'7';~ h~ T C; ;,c/" 1'<150
Data,
S.a Addr_
'1<7 " 71
l.til",. LlI)'
J. VeI'- .VtdOf
TYPE OF STRUCTUR~
Single Fanily
Comman:lal
Y'
Two-Family
Industrial
Multi-Family
Public OUter
Fee Schedule
1% 01 Job cosl ($39.60 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Block Addltlon~S' I'fNO 8ot/^'OS Indusltlal,Commerdal&Mulli-Famlly
OWnar's Nama )"h ~ r /L r ,.,../ __; c;t::./ ~ '" ' ~ldenllal, Healing & AC
I 114\'1 4C} ~'lsldenlial, Healing Only
Address ....r ""..... <: e- - 3~b. U '-ILl']-~? 'dsldenlial, Gas Fireplace
Haatlng Contr-l VW.1IClK HEAitlG (l. AIR GOtII:!'HlJN,"" .. :t . I Resltlanllal, Additions & Altemllons
1:11~1'>I"" " ".........."'., { ResIt' lIIa~ACOnly
Addrass .~ IIIN S64ClO ~ -'I .-
Talaph0n8' . ;.or ~ 7 _ ~ Y' .., l J 'tiemember t~ add the Stala !lulCharge on the bol""n 01 this appllcallon.
Furnace Malta & Modal Or......'" r
t.t>dal Slza rt 7 o))eo 07'
Conn. Load
Lei
~/
. Fual ~/",J ~. LFlua Slza
Supply Openings
Relurn Openings
Input
Edr.
Clm.
. OUlpul
Altaratlons
RBplIlr
Ell. Cost $ '"V.r'f..s-
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAlPERMITFEES $
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mochsnlcal
AIr Condhlonlng
Vant.Syllam
HEATING OR POWER PLANt
Sleam
Hot Watar
Radlallon
Spec;laI Devices
~
\.
~
~
-rv
-/,
~
/
-
.
Olhar DavIcas
TYPE OF WORK
R, ,',;1",., ....
y
Naw Construcllon
;--/v)/c:; .,
qr::J-/IJ{PO
Esl Comp. Data
. BuIcI/ng Parmi'
s .:i J":>
.50
yu,
..~
3~03 /
Rscalpl'
\
,
T' . price 01 your healing permit IncIud88 one rough-In and one lInalln8pectlon.
/~IIon8IInspec\lons will be bRIed al $35.00 ll8Ch.
dS8 Healing Tesl Recotd ....st be subniUed with buIIlIolllllWli l1IIIIbIu: belota build-
.ng cerlllcala 01 occupency wII be Issued.
I:IEAI ~I.AIlQNS REQUIRED whh number ~I oupply and ralum openings listed per
room wtIh CFM's per opening. New slructures or addftlons send floor plen wfth suppty
and relurn Ioca\lons shown. HEAT LOSS CALCULATIONS, PAYMENT AND
,PPUCATIONS MAY BE MAilED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
J CREEK AVE. S.E. PRIOR lAKE. MN 55372.
CRy Hal bulJlness hours are B a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROIJGH.lN AND FINAl) . CALl CITY HALL
447-4230
I hareby apply lor a mechanical syalems permit and I acknowledge thaI the
Inlormsllon above Is complele and accurste; Ihallhs work will be In conlOlmance
with tha oldlnances and codea ollhe cIIy and with the slala bulldlngfmechanlcal
codes; Iho.llhls lorm doss not become a permit unlll algned by Ihe BUILDING
OFFICIAL; Ihat Ihe work will ba In accordance wllh the approved plan In Iha
CBlS 01 all work which requlrea review and approval of plans.
;::7 ~ .--:?~ _44..fZ-~
/~S~
IluIdIng 0IIIc8I.. 51".., ;,-',
.7/<--r9<7
Date
?;/?..h!3J.
- I UBle
DATE TIME
N/~
,(/7t.? ~'~rA'v/ Cr
o FOOTING 0 PLUMBING R/
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL 0 PLUMBING FINAL
o SITE INSPECTION ~ MECH FINAL
COMI'.4eNTS: /_____
/4 j/) h~ ~ d /..:.c,,.. ~ d r' ~
F
/7 /
.Ke C t'" )!.N' ri
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
/)1/'"0 ,L
~ //
(' 6~... ~~<:"" ,776.....
A
/,'y;r
~/
/-;; # q
.-=/
Ul'c
qCj- !blor;
o EXIGRADfFlLLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
-'
-/es/-
./
GJ~
.r
.J"WORK SATISFACTORY, PROCEED
I~ CORRECT ACTION AND PROCEED
o CORRECT WO~ ~INSPECTION BEFORE COVERING
Inspector: ,/: '/~ ONner/Conlr:
CALL 447.9850 FOR THE NEXT /I'l';PECTlON 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR I'OUR PERSONAL HEALTH <I SAFETY!
IN""'"
SEDGWICK HEATING & AIR CONDITIONING CO.
8910 WENTWORTH AVENUE SOUTH. MINNEAPOLIS, MN 55420 . (952) 881.9000
ADDRESS
OCCUPANT
SOLD BY_
MAKE:
SERIAL NO.
-Sf '1 ]
Mac I<-.
-:11IM e
f2." Iif v LA A ( ~U~
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C;9,n3fV\ JLoI>9~
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THERMOSTAT ~- / '1< ! ()O
VALVo / I L)",/./JJI
LIMIT 1/ V',((j ,
LIMIT SETTlN" ,>}_~(/7{-;7 r;
FAN SETTING ,- i j'V] ~1/V
(10J
If:':> I
PILOT TYpf
IGNITION Mon~1
/,_ Ii <;.) (\,.'\11,
"\
r~ \ S
prLOTTIMING _ '(:, <-'",J I !7'v"l r)
-~C::.I( ~
PRESSURE .<.) "lJI. C PERCENT CO 0,
.- ' 0'
INPUT CFH C( Q _ PERCENT 0, -; <.7
~ 'X,) 0 t= -D
STACK TEMP. _ ./ '-', _ PERCENT en
FORM 235 (REV. 11/89)
CITY
HEATING
TEST RECORD
5'il1lL
JOB NO.
k-ov
(;:.4
_ OWNER _ 9u<A-l-
INSTALLED BY .-J; r r / /1"1,-,( r . \
GbO u(.f
'9 DODD
,Ill,
TYPE OF LINER 1.5 J--
&''
Mont::I
INPUT
VENT SIZi=
UNER SIZl::
I=ILTERS: 8171::
WIRING _
TEST TAG
'3~ Bi 0
NUMBER
ZJ./UD
.-----.....-
LIGHTING INST.
DATETESTEn /J /,)b /0 """
COMPANY TESTING _' ~ oJ~
NAME OF TESTER ~ A-O
FORM DISTRIBUTION: rE COPY - JOB FILE YELLOW COPY - CITY