HomeMy WebLinkAboutHeating Permit 08-0096
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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Date Rec'd
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3 _ ( ,
~. ~:w F~icant I PERMIT NO. 08. Oo.fb I
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER 'D
(Name) lY\oL-4{ DcA..r L(L..V'"
(Address) 2-JoOt--b...---ol f\:..().; 1F. 2-.0 l- S-{
APPLICANT
(Name)
SEDGWICK HEATING & AIR CONDITIONING LLC
8910 Wentworth Ave. So
Mm~)S, MN 55420
(952) 881-9000
(Address)
(Contact Person)
APPLICANT SIGNATURE
(phone) bS l-- ZS~ - 1:$ b CJ
cu..,~ '\ fL'l N
S'S\/""
(phone)
(City)
(Zip Code)
(phone)
L-L e-., DATE
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A COMPLETE BELOW
DNEW CONSTRUCTION REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL ~nQ"<.. G'-10u. t\ '2-'4 fill' D FUEL 0':JCAS'
it/'--
FLUE SIZE b RETURN OPENINGS INPUT -'1~, 000 OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
~arm Air Plants 0 Steam
..Q.Gravity 0 Hot Water
((JMechanical 0 Radiation
DAir Conditioning 0 Special Devices
OVent. System 0 Other Devices
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99,50 Residential, Additions & Alterations
$64,50 Residential, AC Only
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $ "'Zf)tXJ, () 0
HEA TIN G PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Buildinl! Official
Date
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.
$39,50
$39,50
$39,50
Building Permit #
$ 3~ - "5 b
$ .50
$ Ye-DD
Paid I~. 00
Date~. /2,0[;;
o. ~() <0
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
SEDGWICK HEATING & AIR CONDITIONING CO.
8910 WENTWORTH AVENUE SOUTH · MINNEAPOLIS, MN 55420 . (952) 881-9000
IGNITION MODEL n Lj I
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PILOT TIMING \ 'f '''')1(1 V\ T
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PRESSURE ~ tJ v,y.. PERCENT CO2
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INPUT CFH 1..[" \.() PERCENT O2
STACK TEMP, .~)~, t PERCENT CO
FORM 235 (REV. 11/89)
ADDRESS
OCCUPANT
SOLD BY
MAKE
SERIAL NO.
THERMOSTAT
VALVE
LIMIT
LIMIT SETTING
FAN SETTING
PILOT r?'"PE
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CITY I ( /0 r L,;;; Y ('
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OWNER /1/; /1 Iii) // f' Ie ,'C:" <:,
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INSTALLED BY ~::~..,.. '-"~ 5"'" 'c (,:,
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COMPANY TESTING ") P r (. \tv, \., 1<,
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FORM DISTRIBUTION: WHITE COPY, JOB FILE
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VENT SIZE
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LINER SIZE
FILTERS: SIZE
WIRING
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TEST TAG
LIGHTING INST.
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DATE TESTED
NAME OF TESTER
HEATING
TEST RECORD
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JOB NO. i . ,).) j
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