HomeMy WebLinkAboutMechanical Permit 03-1607
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFTJU;PLACE PERMIT
Date Rec'd
REQUEST FOR FINAL
INSPECTION SENT TO
(P1ease~ororintandsi2natbottoml HOMEOWNER 01-05
ADDRESS
i ~ ~::y I PERMIT NO. ^? 1(p07 I
3_ Yellow Applicant ~ ~
.JJ4~
.R1vffi~
(!; //'/~ .
I ZONING (office use) I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID z.6. 2-/2.004-. 0
OWNER
(Name)
~.
':f;;/ 4'/)J~
(Phone) qSJ. #7- t:J.L/.z..-
(Address)
APPLICANT
(Name'
SECG'.'VICK HEATING & AIR CONDIT.:::
8910 Weniworth Ave. So.
lAinn"epolis. "1~1 I;<;A?n
(A't!52f 881-9000
(Contact Person) / II (phone)
'-"PLICANTSIGNATU~~ .JrxI//4/////~ DATE /Jk1//l1
~' II .-,n ' f
APPLICANT PLFaSE COMPLETE BELOW
DNEW C~TION !i2l"REPLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEU _'1!Mt- oif/L0Lt-li-J/a,8./J4/J FUEL ~
FLUE SIZE b" RE OPENINGS INPUT c;/) .bI~.I-> <6(TPUT 'kJ -b,t?.t)
TYPE OF SYSTEM HEATINGORPO~'PLANT ~ I
0\Varm Air Plants 0 Steam PLEASE NOTE:
DGravity 0 Hot Water Air Conditioner Units
S'Mechanical D Radiation Cannot Encroach into
DAir Conditioning D Special Devices Required Side Yard
DVent. System D Other Devices Setbacks
(Phone)
(Address)
(City)
(Zip Code)
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit # ()3. / (p 0 7
$ j<1-5o
$ ,50
$ ./p .~~
Estimated Cost $ J 'lL? ,..-
.flee Use Only)
Building Official
Date
r Paid 4-0. d iJ
I Date J OJ
fl.. o.
Receipt N~ 0'1 7
By .-4-.
C/
This Application Becomes Your Building Permit When Approved
24 hour nolice for all inspections (952) 447.9850, fax (952) 447.4245
16200 Eagle Creek Avenue, Prior Lake, MN S5372
HEATING
TEST RECORD
si.f (7 tf
SEDGWICK HEATING & AIR CONDITIONING CO.
8910 WENTWORTH AVENUE SOUTH. MINNEAPOLIS, MN 55420 . (952) 881.9000
ADDRESS
~f &f '3
.M~
:I<WIA; e
R,tkvlA"t f~
-&.b.vi{..(cJ".....
tkv(.,ecA-
OCCUPANT
SOLD BY.
LefA.... oX
S"~03M ;}/gV:\~
THERMOSTAT ---~ ~ 1m tJ:1 t~
VALVE ,j!Jj-/~ ;1
LIMIT -11 _
LIMIT SETTIN~ ~tIIp",
FAN SETTING ~
IlO-(
D0J
PllOTTIMING '~5.t ~.....\- S
PRESSURE 3. -5 "tJ.,C.. PERCENT CO,~.
INPUT CFH ----5...D _ PERCENT O2 ~' OJ rtJ
STACK TEMP.. . '8d · ~ PERCENT CO ----.fJ ..:.-
MAKE
SERIAL NO.
PILOT TYpJ:"
IGNITION MrlnC:1
FQRM 235 (REV. 11/89)
JOaNO.
Pn-irV f:a4 lJ!1
_ OWNER ~AAA. 1j" \ -
INSTAllED BY ~rrf-11t6r "'~r\
GkO U(f "3' 810
_ INPUT ~l? 15)00
~d
~ ~:: :;:INER J3~
/.,p"
CITY
_ MOfll=t
_ LINER ~171:::
-
NUMBER d,i;)CJ'O
_ FilTERS: SIZE
WIRING _
~
.
_ TEST TAG
_ LIGHTING INST.
DATE TESTon /~/.Jr;J~~
, ~ nJ... .J~
COMPANY TESTING <::) ~ -
. j4n
TECOPY-JOBF~CITY
_ NAME OF TESTER_
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TillE
7/~/
ADDRESS
'-, ,...,-
,.,/ '/:.:>
) ....---)
/,7 ..J / ..../
/1v 771"'1"""'''''-,- /'
r;;-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~ MECH FINAL
",'n/
COMM,ENTS:
k;' r'J k<:
F
~rp/~~(" ,/
"5 - 1(,07
r'
o EXlGRAD/FILLlNGL'
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
----
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/WORK SATISFACTORY. PROCEED
/ 0 CORRECT ACTION AND PROCEED
o CORRECT WORK., CAL~F INSPECTION BEFORE COVERING
,r;,ft' .
Inspector: .tf/" Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH.l SAFETY!