HomeMy WebLinkAboutMech Permit 05-0070
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
f.zl.Ot>
1. Pink File PERMIT NO
2. Green City . 0 S. () tJ I U
3. Yellow Applicant
ease type or print and si2l1 at bu~;"...)
ADDRESS
I t,C;rl/ J..VnJS jJ-~ ~ t-
U
LEGAL DESCRIPTION (office use only)
ZONING (office use)
Ie / S.D
LOT 13 BLOCK 4- ADDITION ?f<,/ Of<., 6Ou77i
PID ZS: 017. 0tD ~ 0
OWNER
(Name)
r;;dN'f 0 'f ..sa Ie 1J<!.eF
~~
(Phone) ~c;)..- L./th-.ftfS~
(Address)
APPLICANT
(Name)
.:.~ : ~~ ~ _.:-:~ & Am C.:-.~"
(Phone)
(Address)
(~. ..... ~,~'::.:",; t':}O r~;l /'. \.
(Ad~JcapOliSJ reiN b.~
(952) 881-9000
(Contact Person) I
APPLICANTSIGNATURE7/;~ Ii
(City)
(Zip Code)
(Phone)
DATE
/ ..-/~ ~5
APPLICANT PL ASE COMPLETE BELOW
DNEW CON~~UCTION ~ REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL()('" ~ 11 !J?~LIJi A hB tJ4~ FUEL ~
FLUE SIZE &, 1/ RETURN OPENINGS INPUT CjtJ.~tJ() OU~UT 1J.oOO
J ,
TYPE OF SYSTEM REA TING OR POWER PLANT
[3Wann Air Plants
DGravity
[i;?'Mechanical
[d1\ir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 R~sidential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $ ~.1J t> -
Building Permit # 05. 0070
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
...it;. 6' t!)
.50
t./LJ. (J P
(Office Use Only)
'his Application Becomes Your Building Permit When Approved
Building Official
Date
Paid
+<J.O 0
Date I. U. oS
Receipt No. ~0
BY~
I
24 hour notice for all inspections (952) 447.9850, fax (952) 447.4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/6V/ / ve:>~..s
/
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA nON
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
,...&-IIIE'CH FINAL
I /
~Y~C-e...
COI\IJI4ENTS j.-
(Uflk€e d
,
/J ,.
HCp,I), r!
- / /'
~~ #O($",ft ;j~
DATE TIME
@as-
, I-
fie,
() 5 . 00, 0
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~
O/c
J/~/ / /'
/'Y/C,' {/rl/ .~ .cen.rlo K
/;1%dG'/ # /J/cC-o...?o .',,2J6
(YL ~,1.(- ~rcl'
/
U/<-
-0/
l'
~ORK SATISFACTORY, PROCEED
/'6 ~'ORRECT ACTION AND PROCEED
o CORRECT WORK, C~EINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INS/WTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING
8910 WENTWORTH AVENUE/SOUTH · M~~NEA.P. ;IS;"'Iv1N 55420 · (952) 881-9000"'-0 TES: RECORD
ADDRESS 1 er2f1 !Im<) 1/ j{' ") L CITY- I ( Ii) I &./c\:
OCCUPANT. t r;H:J ,:5'c...t t7 tet" (' OWNER /'"
SOLD BY t-:.)J{A le{ INSTALLED BY _ \ed9Ld, ( >
MAKF !ft1V?-Y ~-_/ MODEL fr6Dt. (-H- )b.8' O'1D- Q.5
SERIAL NO. '5L1 D L' k )S L 1> INPUT. <1< ~l LJ V U
L( \ '
VENT SIZE
TYPE OF LINER ---IS, U-i it,,\
LINER SI71= {j \
FILTERS: ~gE. ~~ 1. ,Xl (
WIRING )iA~'VJ
TEST TAG _ ~
THERMOSTAT )()b 3
VALVE' Ii;.) k ( \ iV\iC \ \
LIMIT F, K e4
LIMIT SETTING / r") L1'
FAN SETTING ~..lltlll {(
PILOT TYPE ~1 l-Q r Vl\' \ 1t~u\
IGNITION MODEl i-l)4::.
PILOT TIMING L6 <R L
PRESSURE ~ l S \ 'vv '\ <-
INPUT CFH _ <is l(-;
-ACK TEMP. S)l) \;:1
---
LIGHTING INST.
DATETESTl=n J.... Ie::; ---0 <;
COMPANY TESTING . (,e d4.-v \ (~
NAME OF TESTER J \ VY\ ~
--
en.
PERCENT C02'~ .IV
PERCENT O2 h
O 1./
_ PERCENT CO
JOBNO.s55b 2.
NUMBER _
FORM DISTRIBUTION: WHITE COpy - JOB FILE YELLOW COPY - CITY
~ 235 (REV. 11/89)