HomeMy WebLinkAboutPermit 4967B 11
AP....L1CATION FOR MECHANICAL PEHMIT
SCOTT GOUNTY, MINNESOTA
L OL. V--e... Permit number !Yi ~ I -" A. II
Receipt number,.;(:5 c:; 10
- - - - - - - - - - - - APPLlCtNT FILL OUT INFORMATION BE~~~ ri?\Ft La...JLe - - -
Project Address Il \~ rY\~\€. LOVV'\.e.... Twp/City ".,.:...It,;..~
(Leave blank if address has not been assigned)
City :p(',' or Lct..\L-e... State VYl V\J Zip 5531~
Applicant,PiJ.Xrt<:J..J ~ l \-e... +{~d- t>tl L. Phone (Home) (Work) 5<44- . <x:cS
~ l'IL f\~
Address \ d. ~~I l"<,."cSc~.:-.:..e.\~ <;0 City SAcV~ State "^ fV ziP5.C::; :),,-8'
OWner(ifotherthanAPPlicant)b~ \t...Jc..~.e...PhOne(HOme) ,'+<to - '+-503 (Work)
Address \, \ ~S ~ ~\-4'-:-. ~....Q.... City =t'qOl' LeJL.e..State m vJ Zip.s 5 3 cd...
Contractor Name ~ 1'\.91.J \ t \-t:. 14 ~ ~ I\-c... Phone (Home) '&"l\ 1.(-- oeo 5 (Work) '8-'ll{- ~o::;>5
Address \~{..81 Qhaol~'.-!..e~IW<-.:5~ity S-Av~ StateVV\..'J' Zip 55~1 R
Project Legal Desc. Parcel No.
Township/City ~r; 0.,..
Section _ Lot _ Block _ Subdivision Name
CHECK APPROPRIATE ITEMS BELOW
BUILDING TYPE: Residential ./ Commercial Other
NewConstruction_ Atteration_ Replacement~ Addition ./ Woodstove_ Other
FUEL TYPE: Natural Gas~ Fuel Oil_ Liquefied Petroleum _ Wood _ Other
FORCED AIR FURNACE
MAKE: b....e..r. n 0 ~
BTU'sfTONS;J S 000
AIR CONDITIONER
~V\V\c>'i.
d 10'" $
*1 ton equals 12,000 BTU's
Round total BTU's of the
TOTAL DESIGN HEAT LOAD
BTU'S r 5, oao
furnace & A.C. up to the
FLUE TYPE
VENT SIZE: next 10,000 BTU level.
LIST IN DETAIL TYPE OF WORK BEING PERFORMED Q...p..p\-,~ l" '*' - hA.VIA~ r,.p .1' A;-I (
Totalvalueofworkperformed~ 4-500.00
I hereby agree that the work for which this permit Is issued shall be performed according to the approved plans and
specifications, the applicable County/City Ordinances and the Minnesota State Mechanical and Building Codes.
Applicant Signature
Date
- - - - - - - - - - - - - - - COUNTY BUILDING USE ONLY - - - - - - - - - - - - - --
REQUIRED INSPECTIONS: Rough-in and gas piping air test: yes _ no _ Orsat and final: yes _ no
Other
I
APproved'i- Denied By Building Official subject to existing regulations and the following conditions:
r
ill ( J171l VI J, M J ./J.J t / ~ -h{)./ ;OtJ.r -9f ~ (!-<J pl1 .
SIGNATUR~ 1:,.11 fLu ..L) jA~ J-../ Date IDf,b/OI
-----~--A--~~~---------------------------
ADDITIONAL COMM~TS:' FEES: Permit 100 00
Plan Check
State Surchargp
1,00
TOTAL FEE
IDI.OO
06600.2821 (4.91 500)
White - County Yellow -Interoffice Pink. Applicant
BUHNSVILLE
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave S, Savage, MN 55378.952-894-0005
Orslat Test Report for JobtlL 700
Address 17115 ih;t/"- i/'J City II !<
Occupant J'y, u" 1;;Jc, t' c P
Dateoflns1al1 10/2'</ /c-Y'
Type of HT. F/A -/ HW Space HT Unit HT
Other
Make & ^'^''' y:.
Model ir 7/vy,3 - 75A
Serial fcX2e>(::> I:T 0 ;3 7? C
Input 7'-: (,)00
Pilot Type HOT SURFACE IGNITOR
Pressure 3, -5 '. C02 "6. 'I
InputCFH 0,ocO 02 i, &>
S1ackTemp 32') '" CO D
Date Tested
Company
Technician
10 It 'I /, I
BURNSVILLE HEATING & AIR CONDITIONING
M.,,/
COUNTY OF SCOTT
INSPECTION NOTICE
PERMIT NO
TOWNSHIP/CITY
04967
B 11
SCHEDULED
COMPLETED
PHONE: 612-496-8334 OR 612-496-8475
DA:rE~_/_ TIME:
200l/U /07
,'.1 .~'7 )
14: 30
_~I 1T
7'1 -
C'C
ADDRESS
JWNER
17125 MAPLE [.N
(H:') '~40-45';:~
CONTRACTOR
D.1\,"'1D
TYPE OF INSPECTION
COMMENTS:
fHrnrtf'~~ Vi llrll /1I.r
(_=x~
"
'_/':~j ,:;_~,., ...;it-
.~ I
z( Work Satisfactory: Proceed
o Correct Work Call for Reinspection before Covering
o Correct Unsafe Condition within _ Hours Inspector will Return
o Correct Work & Proceed
o Stop Work Order Posted Call Inspector
o Inspection Required Call to Arrange Access
BUILDING INSPECTION OFl/{CE: 20~F ~ Avenue West, Shakopee, MN 55379-1220
( I I I
/ I /. j}alV/or the next inspection 24 hours in advance
./ / . 'f/'/ /.
Owner/Contr.on sile ,',f 1 111'llt/'! /..., ,(/~~....:,,{....._~r, InsptfCtor
,",.)
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