HomeMy WebLinkAboutMech Permit 05-0101
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
z..1.0S'
~. ~e:n ~::y I PERMIT NO. 05. 0 101
3 . Yellow Applicant .
!""'" "'" '" Erin' ond "S!! "bo~
I ADDRESS
5 Q10 c::r:m ertllt';.LJ
ZONING (office use)
U
&:
LEGAL DESCRIPTION (office use only)
LOT~ BLOCK z,.. ADDITION jI1.f)(/(;j'A./ 0 fila
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PID U-: a 7.1, , 2.3 ..,f;
I~~~R ~f
(Address) ,
/dmntf-
(Phone)W -'140 -1/7/7'
APPLICANT
(Name)
(Address)
SEDGWICK HEA TINr- f "P "'/'wI'\IT'''~''NG lLC
8910 Wemll,(Atrl nv".
UinnAapolis, MN 55420
(A~2) 881-9000
(Phone)
(Contact Person)
APPLICANT SIGNA TV
(City) (Zip Code)
(Phone) c:;~ f f /, C;t:J~t3
I~/d
DATE
TYPE OF SYSTEM
0W arm Air Plants
OGravity
g-Mechanical
[;J1\ir Conditioning
d OVent. System
"i'~~MAKE AND MODEL U
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
IJ II-t.cU 7
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
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)
,$39.5Q\
$39.50
Estimated Cost $ 77 .s () .r
Building Permit # tJ .s -, cJ I 0 I
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
J.4.~ 0
4tJ .50
,tA'?
Office Use Only)
, This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 10.00
Date 2. 1. ()S
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
~o
OWNER
DATE TIME
SCHEDULED ~~Jr:
/:~~'-c.Jle'-U .
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
~R HOOKUP
/" ~~~BING FINAL
~CH FINAL
eJ)"-?7
as--/'o!,"
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENT~: .r _____ ,/
~I h;€'t! J /&V)t~C,-!.- r--- ~
(o%cS-.Ji!J:9~J
~~~1J}~;;h-~30 ~l
L ~f~
o
~ORK SA TI ACTORY....P.
~ ~ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR INSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
SEDGWICK HEATING & i
8910 WENTWORTH AVENUE SOUTH. MINNL
t RI7 /1/J 'f
SERIAL NO. (<-)9a11i> / S-j 71
V f "60Do
~'
It:)
:~~~:P~ODEL /J 7lS /
PILOT TIMING ~ 51? PI/cis'
PRESSURE S::; 1't.J.( PERCENT CO2
INPUT CFH f t1
STACK TEMP. 1;( r
ADDRESS
OCCUPANT
SOLD BY
MAKE
THERMOSTAT
VALVE
LIMIT
LIMIT SETTING
FAN SETTING
FORM 235 (REV. 11/89)
591o!:A, ier vi PcJ
1:J;y
PERCENT O2
PERCENT CO
fr lar Jq ke
OWNER ~r>'"\ l~_. - f- ?t
INSTALLED BY ~K?tl ole ;9""~
17(PL-1hPV 3t,c oq 0 ~
qo 000
tJd
TYPE OF LINER P (Ie
7 l'
LINER SIZE W
~~-
FILTERS: SIZE c:/U ~
:ONDITIONING co.
_IS, MN 55420 . (952) 881-9000
.5T
CITY
MODEL
INPUT
VENT SIZE
WIRING
TEST TAG
LIGHTING INST.
HEATING
TEST RECORD
J.SSS9~
:# os. 0/0/
NUMBER F3 co
--
-
DATE TESTED
~
NAME OF TESTER
YELLOW COPY. CITY
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