HomeMy WebLinkAboutMechanical Permit #08-0931 �� ' � 'Rtp �i'
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Monday, September 16, 2013
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Current Resident oS�,
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Prior Lake, Minnesota 55372 ,��e to f �� r��
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Re: Building Permit Number �` . We request your help
�E- �D A� i r Cw�,� L�. � onc �2..
In review of the building permit files, it was discovered there is an open permit for
�t the above address. Please call by Monday, September 30, 2013 to set
up an inspection. If there has been no contact from you by this date, the City will
deem the permit abandoned and invalid. (per State Building Code R105.3.2). This
permit abandonment will be recorded in the permanent public record for this
address.
Any new work relative to this type building permit will require a new permit along
with new permit fees.
Please call the Building Department at 952 to schedule your inspection
date.
Thank you for your cooperation,
, Sincerely,
Building and Inspections Department
� City of Prior Lake
TING & AIR CONDITIONING CO HEATING JOB NO. �/� �
SEDGWICK HEA TEST RECORD
8910 WENTWORTH AVENUE SOUTH • MINNEAPOUS, MN 55420 •(952) 881-9000
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ADDRESS � �jJ � U S ��
OCCUPANT �� OWNER ,
SOLD BV • , �r • ' � INSTALLED BY
MAKE �m.1./s-�z{ MODEL `�' �
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INPUT � '�"-""
SERIAL NO.
THERMOSTA ��—f�_h��� VENT SIZE
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� , TYPE OF UNER . �� �� Q��
VALVE �/�
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LINER SIZE
LIMIT r i
''') FILTERS: ZE �� NUMBER
LIMITSETTING�—�j O p , /1� .�-r `
FAN SETT�NG
�i�„ —� ur {� WIRING �/ ��7jj �I /L�f X ����1 ��
� D n..f _ M l� TEST TAG
PILOT TYPE
IGNITION MODEL � " � '' LIGHTING INST.
PILOT TIMING � � DATE TESTED � ` " �
c t � �ERCENT CO � �
PRESSURE '
r_ d b COMPANY TESTING
INPUT CFH PERCENT 0 ���
STACK TEMP. __� PERCENT CO NAME OF TESTER '
FORM DI5TRIBUTION: WHITE COPY • JOB FILE YELLOW COPY - GTY
FORM 235 (REV. 11l89)
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o � r R jo � CITY OF PRIOR LAKE Date Rec'd
� � HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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+� � .SQ� 1. Pink File � /
I �'NES� 2 . ��„ �,�, PERMIT NO.
3. Yellow Applicant i O
lease e or ' t and si at bottom
ADDRESS ZONING (ofieice use)
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
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(Address) � �
APPLICANT LL
(Name) 8910 Wentworth Ave So (Phone)
Minneapolis, MN 55420
(Address)
Ad ss (City) (Zip Code)
(Cont�ct Person) Y' - (Phone) �,, � O �l — �[3�_
APPL,iCANT SIGNATURE, _ DATE � b _ ��J -C� �'
APPLICANT PLEASE CO LETE BELOW
QNEW CONSTRUCTION REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL L. � U � FUEL ��S
I/
FLUE SIZE (�p RETURN OPENINGS INPUT D �DL') O PUT '7
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
�arm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
[�If�echanical ❑ Radiation
g ir Conditioning ❑ Special Devices Fireplaces with Bog Additions or
Vent. S stem ❑ Other Devices Cantilevers to the Outside of Buildings
R�r � Require a Building Permit.
��bAE��MAKE AND MODEL C b
FEE5CHEDULE
Industrial, Commercial & Multi-Family 1% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ Building Permit #
HEATING PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ _�i P�, D �.
�ot��e use on�y� �
This Application Becomes Your Building Permit When Approved Paid � J � ce pt No. ���
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Date� ! , ` L� U
Buildine Official Date { T '
24 hour notice for all inspections (952) 447-9850, faz (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372