HomeMy WebLinkAboutMechanical 00-0635
c/~03S-
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB NO fJ9 0
(612) 881-9000 TEST RECORD
- CITY_ IDA J....~
- OWNER _
f1 - INSTALLED BY :;"O~WJc., E/9T/N.
-
MAKE J... );( - MODEL Gc..S/~ -ObO -,~O- 'J. V
SERIAL NO ----! ." 60 7 - INPUT j 2.,
.
THERMOSTAT -L -\VEt.. / - VENT SIZE D I p.( g}Vr
VALVE Ifn" J..t....- II j ~ ;J. oC;- TYPE OF LINEA -
,
LIMIT T.o - /3 LINER SIZE -
-
LIMIT SETTING ~ FilTERS: SIZE dm NUMBER
()~ - ~ ~
FAN SETTING_ - WIRING
PILOT TYPE -L ,... FIA TEST TAG ~
-
IGNITION MODEL SD 1-/ ( 7b~g( ~ 1.;1 LIGHTING INST,-=-
PilOT TIMING_ ,
PRESSURE ~ ,.,( DATE TESTED------.J
PERCENT CO2
INPUT CFH J.-.:. / I ");; COMPANY TESTING
PERCENT O2
-0'-
STACK TEMP.---, PERCENT CO NAME OF TESTER
FORM 235 (REV. 11189]
I
i
I
I
Lily
ContI.clOt'
Yellow
l.
OO-OtP3tf
MC
Permll No.
.E.
Mulll-Famlly
Other
Two-Family
Single Family
Comme,clal
Public
1% 01)00 cosl ($39.50 minimum)
$99,50
$64.50
$39,50
$39,50
$39,50
Indu;;lrlal
Industrial, Comme,clal & Multi.Famlly
Resldenllal,
Resldenllal.
Resldenllal,
Resldenllal,
Resldenllal,
..........
Healing & AC
Healing Only
Gas Fireplace
Addillons & Alte,allons
AC Only
Fee Schedule
HEATING APPLICATION I PERMIT
Block __
Owner's Name
Address
Date
She Address
Lol
Heating Contraclor
Address
Remember to add Ihe Slale SJrcharge on the bollom ollhls applicallon.
Telephone "
finallnspecllon.
rough-In and one
....,ed at $35,00 each.
-
Includes one
(". 0&0- 100
I
~.:S
Model Size
bulldina Ili1IDilIllllDbm before build.
'LOMS BfQUlBal with number 01 supply and relurn openings listed per
er opening, New struclures or addillons send lIoor plan with supply
shown, hEAT LOSS CALCULATIONS, PAYMENT AND
, BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
..0.:. PRIOR LAKE, MN 55372.
business hours are 8 a,m.
v
~
\~I~)I~~~\,\J~ ,\0
_ C\,oS~\) ,\<0{
\~I'>C'\\~\
HEAliNG OR POWER PLANT
Steam
Hal VIIaler _
Radlllltlon _
Spec'al Devices
~ /2LJ Flue Size
S~pply openings
Return Openings
Inpul 100, /) lJ{) OulpUI
,
,>onn. Load
Fuel
CALL CITY HALL
" 4:30 p.m,
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) .
riall
-,
OIhe: Devices
Edr.
I hereby apply lor a mechanical syslems permll and I acknowledge Ihallhe
Inlormallon above Is complE'ts and accurate; Ihallhe work will be In ~onlormance
wllh the ordinances and codes of Ihe clly and wllh Ihe slale building/mechanical
codes; Ihalthls IorIO does hOl become a permit unlll signed by the BUILDING
OFFICIAL; thatlhe work will be In accordance wllh the approved plan In the
case 01 all work which requires review and approval o' plans.
crh,
447-4230
TYPE OF WORK
Rsptacamenl V
ClIO.
New Conslrucllon
-oC!..
00-6&:35
PE OF SYSTEM
Warm Air Planls
Gravity
Mechanical _
Air Cc.ndhlonlng
Vent. Syslem
7~
Building Permit "
to oJ. Jjo
Comp. Dale
Esl
Alterallons
Cos! $
Repair
Est.
3f';625:
Race"l "
.50
10
toJ
HEATING PERMIT FEE $
$
TOTAl PEAMITFEES $
STATE SURCHARGE