HomeMy WebLinkAboutMechanical 99-1263
CITY OF PRIOR LAKE
INSA~CTION.NOTICE
SCHEDULED
DATE TIME
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ADDRESS / L/ (., q L b~ A A~".j
,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
9 9- /d.~ <.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL ~ 0 .GASLlN,E .AI~\ ~~I1J .r
o MECHFINAL ~Al)(\"~
COMMENTS:
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( _ ORK SA TISFACTOI'\ r , t"1'\V\Oau
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
lNSNOTl
I
SEDGWICK HEATING & AIR CONDITIONING CO.
8910.WENTWORTH AVENUE SOUTH . MINNEAPOLIS. MN 55420 . (612) 881-9000
ADDRESS
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OCCUPANT
SOLD BY
MAKE L It/} /l t? .><
SERIAL NO. J ~,~ .4 0 7 q :;L D
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THERMOSTAT
VALVE Ht7h?~ wc, 1/
,
LIMIT L .?/\^O:X
LIMIT SETTING fil><~t/
FAN SETTING + """" t-r.I
PILOT TYPE /1" ( t- t:-..f-(' I"r.
IGNITION MODFI l.tI'l^D.X
PILOT TIMING
/?(~vfr,(.
3,.5';' .,j' G.
"0
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PERCENT CO
PRESSURI=
PERCENT CO,
INPUT CFH
PERCENT 0,
STACK TEMP.
FORM 235 (REV. 11/89)
)
. ..:ATING
TEST RECORD
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INSTALLED BY 5~ ~ ~
CITY
OWNER
MODEL
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!?t)II'J/)f)
INPUT
VENT SIZE
4'4
..g V ?^f
7" ,1
TYPE OF LINER
LINER SIZE
FILTERS: S171=
WIRING /1-4,(', ~O /)
TEST TAG
LIGHTING INST.
DATE TESTED
g-
b
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COMPANY TESTING
NAME OF TESTER
FORM D'STRIBUTION: WHITE COPY - JOB FILE
YELLOW COPY - CITY
JOB NO J(9 ;21/
.
NUMBER
Block
Owner's Name
Address
Heating Contractor
Address
Telephone ,
F~~Model~'i.
Model Size (" b. /)(J~
/
Conn. load
Fuel~
· Supply openings
Return Openings
Input
1
Eor.
Cflfl.
Alterations
Repair.
Est. Cost $
$(
Flue Size -1R
Output
LFJ.tI-&JA TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vert System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
-
Other Devices
TYPE OF WORK
New Construction
Replacement
Est. Comp. Date
Building Permit II 99- ( 2. '=>3
Jet. So
.50
4/Jj)O RecEllptll 3VJ44-5
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
riPE OF STRUCTURE
L. l,ltc'n
3. Yellow
LIly
Conlnclor
Single Family
Commercial
/
Two-Family
Industrial
Public
Multi-Family
Other
Fee Schedule
/
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Resldenlial, Additions & Alterations
Residential, AC Only
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
0&1198
Remember to add the Slate Surcharge on the bottom of this application.
The price of your heating permillncludes one rough-In and one final Inspection.
Addilionallnspections will be billed at $35.00 each.
House Heating Test Record must be submitted with building RmmilIlWllb.m before build-
ing certificate of occupancy will be Issued. .
HEM CAlCUl,ATIONS B..I;OOIRED with number of supply and return openings listed per
room wilh CFM's per opening. New structures or additions send floor plan with supply
and relurn locations shown. HEAT lOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAIl.ED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL
441-4230
I hereby apply for a mechanical systems permit and I acknowledge that the
Inlormation above Is complste and accurate; that the work will be In conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUilDING
OFFICIAL; that the work will be In accordance with the approved plan In the
case of all work which requires review and approval of plans.
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Date
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Date