HomeMy WebLinkAboutMech Permit 05-0453
1J-.s~116
~ CITY CF PRIOR LAKE
€ / 1\ ~ HEA TING/AIR CONDITIONINGIFIREPLACE PERMIT
~E5Y
Date Rec'd
520.05
~. ~n ~:~ PERMIT NO. O~. 0" c:''2
3. Yellow Applicant q-':J J
(Please type or print and si~ at bottom)
ADDRESS
/7/7 S J~, C/rd-<,
ZONING (office use)
LEGAL DESCR!yuON (office use only)
LOT
BLOCK
ADDITION
PIDz.b. 4-22 . 007. 0
OWNER
(Name)
~~
/bJ/tM~
(Phone) 0/,",0- 'L4tJ -~t4 If
(Address)
APPLICANT
(Name)
SEDGWICK HEATING fl, AIR CONO'T'CN1NG LLC
8910 Wt:mlworth Avi;; vI.;
~ 1innsapohs. MN 55420
(A_ 881-9000
(Contact Person) - . I (Phone)
PPLlCANT SIGNATURE"""'/ fJlrf/t1J!J .eJ. ~ DATE ~/t .,tJ:r
APPLICANT PLEA" COMPLETE BELOW
DNEW CON~UCTION 00 REPLACEMENT 0 AL TERA nONS
FURNACEMAKEANDMODEL~ b~IJLdfJ.blL.LJ~t) FUEL ~
FLUE SIZE }P" RETURN OPENINGS INPUT 11/t1tJIJ OUfpUT~~P
/ ,
TYPE OF SYSTEM HEATING OR POWER PLANT
(Phone)
(Address)
(City)
(Zip Code)
~arm Air Plants
DGravity
0"Mechanical
0'Air Conditioning
DVent. System ,I.
&1:LI{CE MAKE AND MODEL ~
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
/.1~~JL/ I ~m)
-'--_ ..J
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 & AIC (New Construction)
Residential. Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
cd ~.s'c:?
.50
L..kJ, tJ(2
.lice Use Only)
Building Official
Date
Paid 40.00
Dat~.ZO.05
Receipt No. #3/0
BY~
This Application Becomes Your Building Permit When Approved
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
17/7y
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
~)
~ I
~.. .
. ~ v _ ~, ,~
DATE TIME
SCHEDULED ~,(1~0"
[Jq GfV
CONTR.
PERMIT NO. S-<;t.(S)
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
rVhf44.. / d-t.-
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J~ '~
----, ~
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( / { ,\1"___ (({ -e- ')
\. ~'- /
"-- -------
~J-.- ~/-qd(j}
o WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
#' CORRECT WO~~LL FOR REINSPECTION BEFORE COVERING
Inspector: JIt,If/ Owner/Contr:
- .
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSI<<JTl
SEDGWICK HEATING & All; NDITIONING CO.
8910 WENTWORTH AVENUE SOUTH. MINNEAPOL._, ,vlN 55420 . (952) 881-9000
HEATING
TEST RECORD
JOBI
C;C/ ( b
ADDRESf' /7 I 7 5?
IbA-
\
elf'.
CITY SiP f' I ,-0 C; L.o ~('T Lv P
OWNER _ k -e €> r0 ,q-...... c( I A LJ {I'+~
.+63
o
MODEL _ 6 6 0 U I~ 36 A-O 7 6~ 05 .
INPUT -.--..6~ //2DD -
((
VENT SIZF V
TYPE OF LINER J3 -IJeni
/' I~ -
LINER SI71= ,...
FILTERS: SIZE ~5:f'U . NUMBER
WIRING MY
~ ~
INSTALLED BY
OCCUPANT
SOLD BY S' c? Fi<tf c.:u ( (": 4-
k~.AJAlcrY
SERIAL NO. t)x1)5PB~~bJ
MAKF
THERMOSjf ;?]{ 3
VALVr: 1lPnlllJl pI!. /)
LIMIT n>t eiI.
UMITSEmNG. nO~D~
FAN SETTING -& _
PILOT TYPE :J';,.}.t. .
IGNITION MODEl Iis1
PILOT TIMING _ is'St:t:
3 If
PRESSURE & LP\ G PERCENT COo
INPUT CFH 6.6
STACK TEMP. 3{)) v
TEST TAG
PERCENT O2
~'()
b ~1;1
D~
LIGHTING INST.
DATETESTEP 5 "'J-o-r
COMPANYTESTING - 'Vd !:i0J I ~
NAME OF TESTER J'\))v1 - ~
PERCENT CO
FORM 235 (REV. 11/89)
FORM DISTRIBUTION: WHITE COpy - JOB FILE YELLOW COPY - CITY