HomeMy WebLinkAboutMech Permit 05-0127
CITY OF PRIO~ LAKE
HEA TING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
2-;1 B .05
(Please type or print and si2l1 at bottom)
ADDRESS
1. Pink File PERMIT NO
2, Green City .O~ _ 0/-' -t
3. Yellow Applicant ~ V I
ZONING (office use)
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.1J7/fJJtZS ~j I S C,
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2S. 1(,5. 039. 0
OWNER
(Name)
:I~_ L rt:lA!J
~)hAn~~
..
(Phone) !is;... 1./ LjtJ.. ? 'II:, 7
(Address)
APPLICANT
(Name)
(Address)
SEDGWICK HEATING & AIR CONOITIONING LLC
89,10 Wentworth Ave 30
Mln~o!t Mr' ,..,.. '-.'"
( ffS I V , \J.J'ot~v
J 1-9000
(Phone)
(City)
(Zip Code)
(Contact Person)
DATE
~?M.5
(Phone)
//~~ ~
~
APPLICANT PLE SE COMPLETE BELOW
DNEW CON~UCTION riI REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODELC'1/~ ~V J6e IJ?O FUEL ~
FLUE SIZE ~ RETURN OPENINGS INPUT ~..tJC;t) O~PUT t:,~.#~,!)
TYPE OF SYSTEM REA TING OR POWER PLANT
'{3W arm Air Plants 0 Steam
DGravity D Hot Water
flMechanical D Radiation /)
~Air Conditioning D Special Devicevl~
DVent. System D Other Devices
F~KEANDMODEL UfJLje?X .H~XfU5 ...tJd.L/
APPLICANT SIGNA TU
,
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
t-l+m
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
( $39.5.D1
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.j~~o
_ .50
"#J ,IJ/)
lice Use Only)
, This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid +0. cro
Date /8 0 c:-
Z~ . ~
Receipt No. ~!;807
By ~
I
1-
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
DATE TIME
CITY OF PRIOR LAKE -
INSPECTION NOTICE SCHEDULED 3~2J.~j
ADDRESS S7LI fl1. ~~
OWNER CONTR.
PHONE NO. PERMIT NO. -.5-/2-7
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
(
"
~
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COMMENTS:
./WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND OCEED
o CORRECT W OR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
,
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNon
--
SEDGWICK HEATING & AIR C lITIONING COo/7)<< (J-1EATING
8910 WENTWORTH AVENUE SOUTH · MINNEAPOLIS,. _0420. (952) 881-9000 U c:J TEST RECORD
57 ;) I fV/~/.-x--;::) I CITY /~ O:?~ /.~ I r
~ d OWNER '0l! (k Is rc-R ( ~
C WA fv.r INSTALLED BY _ 744 /?l~ ~ ~;,? r:"",., ~~~
/ . d
[, /...-/ .l!21 v~ ~ t?"7 0 0 (
7 (J /J 190
ADDRESS
OCCUPANT _
SOLD BY
MAKE
SERIAL NO. .
THERMOSTAT
VALVF
LIMIT
LIMIT SETTING
FAN SETTING
PILOT TYPE
INPUT CFH _
FORM 235 (REV, 11/89)
JOB NO,
'ts-/
bt'1J 11;l/Y ""'0' IJ /
s9t.J L-! f/YlV 0- eLL {/
J/jP gtJ&C7
MODEL
INPUT _
VENT SIZE
d't
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V../ V L
c9 {"
c-
/A~
II/'d't/ .
C;;Vc/d'( -~~':'
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f7(()vzJ
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IGNITION MODFI , 1+ C;;; ( J
PILOTTIMING ~ 5rl Lc9V> ~
PRESSURE 3:5-'" ( ~PERCENT CO2-
?tJ
PERCENT O2
('clJ 1!1 r
STACK TEMP r PERCENT CO
TYPE OF LINER
/ . tf
LINER SIZE LO
FILTERS: SIZE --C)/;/ ;<d{S f.-/
---
WIRING _
NUMBER
;:;;;)00
TEST TAG _
LIGHTING INST.
"8 %,
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0-
YELLOW COPY. CITY