HomeMy WebLinkAboutPermit 3854B11
Al-. L1CATION FOR MECHANICAL PE...V1IT
SCOTT COUNTY, MINNESOTA
Township/eiIy
.s\.-
Permit number '?, ~"")Li -B.-I)
Receipt number \ '"3, "-13 """
- - - - - - - - - - - - APPLICANT FILL OUT INFORMATION BELOW: - - - - - - - - - - --
Project Address I 7/ f"J & k ,).<;':/..."'-0 uJ,J R 1\ Twp/City ,<;"11" uJe i. AKe fuJl.
(Leave blank if address has not been assigned)
City
{J/),nR..
J..A:I<.F;
Zip ....5:'53?a
State i-r r-1
ilJL
Applicant :5VPE?R,c.e &..;-rAA-=:nl>...._ Phone (Home) S:-:f?-l?<r"'i'f (Work)
Address tlf~,1 I/:a........t/ A-vc::. /V~ City (!~YSfA.L- State H;./ Zip S:SY:J~
Owner (if other than Applicant) C R Al C :::70 Hr.lS"~hone (Home) </'17- ft,3 ~<( (Work)
Address /'){?&, Mu$fln..u.J R.r-, City/kIOR. LItK;:5 State 1-"; Zip s:J3?:J
ContractorNamS(.IjD~(\~ ~rRA-O'lJRS /Ak:.. Phone (Home) 53Q-ll"-/ft/ (Work)
Address &(~ 1'tl~ Ave .uJ City {f~Y.-:trJt-L- State kJ.1 ZiPSsYa.::?
Project Legal Desc. "Z....)...-;}. c, ~ (\)\, \.iu Parcel No. .11 - D I 30Q1.:../\
Section -U- Lot --L Block _ Subdivision Name .~'{\ A- S? \ .L P. c \\:1 <, <....
CHECK APPROPRIATE ITEMS BELOW
BUILDING TYPE: Residential-X-- Commercial Other
New Construction _ Alteration _ Replacement X Addition _ Woodstove Other
FUEL TYPE: Natural Gas-JC- Fuel Oil_ Liquefied Petroleum _ Wood _ Other
FORCED AIR FURNACE AIR CONDITIONER
MAKE: R.ulJh t/qj?/1rnr]
BTU's(TONS:
*1 ton equals 12,000 BTU's
Round total BTU's of the
furnace & A.C. up to the
TOTAL DESIGN HEAT LOAD
BTU'S
FLUE TYPE Ai e....,
VENT SIZE: next 10,000 BTU level.
LIST IN DETAIL TYPE OF WORK BEING PERFOf\MED 1="u R ~ 1}~6' ~= ..piA a6-k ~r
cf- L IrJe:1'I:.. ,:::off!. wAf e;-,,?. ~
(
~ 'J~ ~
Total value of work performed $ 0<.:) QO
I hereby agree that the work for which this permit Is Issued shall be performed according to the approved plans and
specifications, the aPn~~unty/CIty Ordinances and the Minnesota State Mechanical and Building Codes.
Applicant Signature rl lir"v.. Date 1- IJJ -9 r
- - - - - - - - - - - - - - - COUNTY BUILDING USE ONLY - - - - - - - - - - - - - --
REQUIRED INSPECTIONS: Rough-in and gas piping air test: yes _ no _ Orsat and final: yes _ no
Other
Approved -!l5... Denied _ By Building Official subject to existing regulations and the following conditions:
--I'LL.' 11.&1)11.. A"n
tlJATCA./At- Fa ~7
~h?~ ~J::JIP
SIGNATURI=
Date
ADDITIONAL COMMENTS:
FEES: Permit ,5D€?S--
Plan Check
State Surcharge ,SV
3\'-\
TOTAL FEE _~ D,S1)
06600-2821 (4-91 500)
White - County Yellow - Interoffice Pink - Applicant
rt:.~v..."
t:i: 38's.,' [J, il
1-13-'17
SUBURB r11~ / ;,Jc
ADDRESS
OCOJPANT
HEn LOSS ../
SOLD BY m LJ
I7l7f
HOUSE HEATING TEST RECORD
17J/iS I ;;"t.-'7~ ;2,,1'
APT._flO:JR_CITY .
OWNER
/rfJ/"
-\7./. <'-""-_
D"TE HTG. INST.
EI.ct,ical Work By
TYPE Of HE.... T
IHSTALLED BY 5 /,,"IUa--L:~- (',--;,~_i:7;~ i7-
Go a Un., By
G,t. ~ FA _._HV{ _______:-;5t'Y ~~ ;::!';':': ,-;Tk. _Jf"iT r-\TR. _OTHER
/..{j/f~:.,'./ 1
B /,/7;.
/
MAKE
Mod. I
;Z".tiJ /.{
((1-t?4-c7E()!;/<.5
GAS DESIGN
CONVERSION
MAKE OF BURNEP
Mode!
~.<,:-:-J _l~~~_r'-:;'
INPUT -;;:.(" ./"Z-'(~j
Mo.. BTU Ratinr
MAKE OF FURNACE
Madel __
THERhtOSTAT
Valve 1/ u/'
II '..
rr-:,;"-'~'rWL:'
I _ :,-'" P' ~~
Ii-a.>" H.-c\ . OJ;
.-,-
Vent Six.
;;;. Ii
Ll"'f'
L;mlt 5.tting -'--J,.-"-y;'~
Fen S.ttin" ,:1/ r" ...~'
Pilot Typo/I..r V.,-4~c
Pilot Mak. /:1.;,./ /
KIND Of LINER
Drof1 H()od
SIZE
NON~ //
Filt.r.
O.lrntl*y Location
o,jrnney Col'\1.ttu<:tion
Siu /".~ Yd~ ':X
ReguloTor
NJ;V"b.r
lnaia. -1
$'(-'(
/
OuhiGe
-
Pilot Mod.1
Pilot Timing: / ,..;J_ <' c.
L.W. Cut 011
Pr.uur. ?:- (~
l"I'u' CFH .A.-
Stock T.",pI?"'\' C
f(lorm 235
Smole. Bomb
0.0/1 ,.&/- /Y
Wiring ;r
T.., Tor' ~;Y
Lighting Ins;'h
Door Pr.ssur.
P.r~nf CD )
Poreont O~~----
P.r~nt CO /.7
Dot. Tut.. /-/f- 9/2
Company i..tin; S Lr1//.-~-;- c.:f~,/f;
No,.,. (Jf Tost.r #"";r/_,";t:,;-z""
COUNTY OF SCOTT
INSPECTION NOTICE 3'?,5"''/-t$ -II
00000 B 00
SL
PHONE: 612-496-8334 OR 612-496-8475
DATE---1---1_ TIME:
SCHEDut~/03/24 10:30
COMPLETED
PERMIT NO
TOWNSHIP/CITY.
ADDRESS
OWNER
17176 MUSHTOWN RD
JOHNSON
rONTRACTOR~UPERIOR
TYPEOFINSPECT~ heating final 0
COMMl}'p: (lJ) (l.l...uJ..- A...('/I rp~ ;:tc A?e ~o
r~&> J ibtfI- ..IU~ .:'1 ~ ~.>v. .
~)
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~~~~
~ 'Ill D.-ll.Ul I~
IP,M. M./
t~
" Z"
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~
o
o
Correct Work & Proceed
Stop Work Order Posted Call Inspector
Inspection Required Call to Arrange Access
o Work Satisfactory: Proceed
o Correct Work Call for Reinspection before Covering
o Correct Unsafe Condition within _ Hours Inspector will Return
BUILDING INSPECTION OFFICE: 200 Fourth Avenue West, Shakopee, MN 55379-1220
Owner/Contr. on site
tf)
/7 Calif or the next inspection 24 hours in advance ~
lS /trA f-4 Inspector \
- ~ -