HomeMy WebLinkAboutBldg Permit 04-0754
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
Main File
I. White File
2 Pink City
3 Ye\low Applicant
b/ d-5 -/()~
I PERMIT NO. 0 +. 07 s44
(Please type or print and siJtll at bottom)
ADDRESS
4e70
&OFf' #&7:6)17S
7RAJ'1. .
ZONING (office use)
PU()
LEGAL DESCRIPTION (office use only)
LOTS'Z BLOCK OJ ADDITION
T:rMAGR.
G/MJT
lH~k.
PID aiY- L/()J.-~d -./)
OWNER
(Name)
tUL.iE
dAWi'{
#()I.71IvE.tr
P/1lJ,~ IA//I 4j
Sw74f- /4~,
(Phone) 'r/- KZ - ~~b
L/ft:.4A/ /FI~ Sr/21
(Address) '~/C
BUILDER
(Company Name)
(Contact Name)
(Address)
5 A At 1':-
c.uR. r /]l.. /f&e.H/<"a
(Phone)
(Phone) '-12 - Z z/ - ." as-
TYPE OF WORK ~ew Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition o Alteration OUtility Connection 0 Misc.
CODE: ~I.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
mIVVA
HIM R
2 3 4 S
B
S U
PROJECT COST IV ALUE $
(excluding land)
?~~~
official can ~e tjf pelmi
X' ~
- /
I hereby certify Ihatl have tiJrnished mformation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
'uction will conform to all exisltng stale and local laws and will proceed in accordance with submitted plans. I am aware that the building
Fm1hermore, I hereby agree that the CIty official or a designee may enter upon the property to perform necded Insp.cctions.
Ec.-- /371 ro /1,$"/"4'
Contractor's License No. -Date '
-Signature
I Permit Valuation 19t" 61)0. O() \ I Park Support Fee # $ . I
1 Permit Fee $ /627, so I I SAC # $ f3so,00 I
- --. ......
I Plan Check Fee $ to ~ 7. 'i/K I \ Water Meter (Sifie 5/8'\)1"; $ Z~O. oa \
1 State Surcharge $ lft. 00 , , Pressure Reducer $ tf~. 00 I
I Penalty $ I Sewer/Water Connection Fee # $ ) '2..e) o. 0 tJ I
I Plumbing Permit Fee $ IDa ~ 00 I Water Tower Fee # $ 700,00 I
I Mechanical Permit Fee $ lero.OD I Builder's Deposit $ ISeJO, 0 C I
I Sewer & Water Permit Fee $ 35". ~o I Other $ I
\ Gas Fireplace Permit Fee $ tfo , 0 0 \ TOTAL DUE ~ 1 :71~ ,04--' $'l ()c,Z;. e~
- ,
This Application Becomes Your Building Permit When Approved
~m'~~ ~</
~~
I Paid r I (J h 3 ' ~ ~
I Date -J - ;;SO'" (j
Receipt No. l-I "l Cf .:3 c_/
BYJ .
ThJS IS to certify that the request in the above applical10n and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner conslJ!utcs a temporary CertifIcate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
iS~ ~~ 76~'( U ~ ~
Planning"Director . I' 'Date Special Conditiontlif any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Main File
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
White - Building
~"'laJV - ~ngll'eer IIlb
Pink - Planning
Th. C.nler 01 Ih. tlke Counlry
NAME OF APPLICANT
APPLICATION RECEIVED
IJd2u r&t11UCJ
,
~ -0 ~-1?L/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction ~; ';~h is ~ ~ ~
I / \../
'/
Accepted
~~:
Accepted With Corrections
Denied
Reviewed By:
m4'D
Date:
7.. /5 -otj
,
Comments: See Reverse Side for Acidition~1 \nfarn1~tioPl
~/'" ':-//t /
See Attachments~ 1) firading Plan, 2) Rro~ion Control MpaSl.rPQ
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the Jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
Main File
__ - Buils;l~
Canary - Engineering
Pink - Planning
Thf' C'f'ntn of Ihr tab ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
<:j)~ ~
/~- ~5-o<-l
I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for conslruc~ ;~~ which ~ al:1Jl;, ~
Accepted
Accepted With Corrections
/
Denied
~€-0n-' ~ ~ Dale: ~// y 4 </
~ d-U ~~I
<::.. -
Reviewed By:
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
='
Mall! i::ile
White - Building
Canary - Engineering
<"'!fnk .- Planmnb
The Ceo'e, of Ihe tlke COnOllY
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
<:}J~'" ~-~
(/- 95-0<-/
- /
~""I''''c
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is ,-.proposed at: ri IT ./f .
Llf~O U1fJ ~ ~
Accepted
Accepted With Corrections /
Denied
Reviewed By:
Comments:
~
.12L~
.
~~ Date: 711:l~c./
/ --
6U{ ~~~~
tJ
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3_ Yellow Applicant
'1~
PERMIT NO. 75(0
75;
(Please type or print and sign at bottom)
. ADDRESS
Ljg-70.487;;1. 49'/Lt Lfe7h 1f1",/){JA<@,"o"-h. ~ ~r-/
" :./
ZONING (office use)
LEGAL DESCRl.t' lION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
Pu/I~
(Phone)
(Address)
APPLICANT 1')1
(Name) Va.d'<-j Ot...._\-'~/~:j ~ c.~
(Address) ~d (;A '-'rCue~_ At.-~
(Address)
(Contact Person) C-/1 r ~ '-s M t> rr l:..s'
APPLICANTSIGNATUR~~&'
- - -
V
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(Phone) q S~-o/9~ - 01 /;;J/
-:ro~~ M N SS 6SO:<
(City) (Zip Code)
(Phone)
/-0
..
ri-~ ty t. -r- .
DATE
g- -.~ 3 .. (:)7'
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
Building Official
! i
Paid g"/ d-::S-U'-' Receipt No.
_ rJ.y J
Date Date A v. & I BYB-
'P )
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 .
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Jul 20 04 08:24a
METRO GENERAL SERVICES
763-428-2968
p. 1
GAUlt - FLE
YElLOw. Af'rLlCA""
OO"D - CIT'I
2.
3.
4 .
"-.... 5 .
.
~, 6.
NOTE: Sewer and Water
contractors must
be registered
with the city.
(V~ ' t../ ' ,.).--:"
APPLICANT: ~jil~{) ~ y 'Jtf~l)YI( ..')err6oNE:llfj3..j-l2t()~r)k
ADDRESS : ./-l7~t) (j !;l1nl l.Ji.If~ /I.f DATE:
SIGNATURE: - - i)o iflJ:t}t:f-[ - BLDG. PERMIT #
SITE ADDRESS: LfS..7(J /\IiYL;C' !:thp/l/\ 7j..-FID#
.F'ILL.:IN THE BLANKS
1. Estimated length of water service ij~~) feet.
Size of water service ! ilj inch (es) .
Location of any couplings from structure (OJ feet.
I J i
Type of sewer pipe. ABS PVC L! Cast Iron
Estimated length of sewer line .~;f) feet.
CITY OF PRIOR LAKE
SEWER' AND WATER PERMIT
FA y.. <i5~ 'I" J-tf-z, t/$'"
s.w. No.lL+. tgSJi
Clean out (if required), located at feet from
====:::~::~::~===================~===i~~==~======================
This application becomes your permit when approved.
,!
BY
DATE:
~.' .~(~';; ".' .
===========-T-=========~==~======================================
P wi /eJ /.J , 'f1r '
FEES :11/d.j P~t./k I- =r- _ c Sewer and water line connection permit.
_' , ,Surcharge
N'C/ '-e,.e- TOTAL
* Fee for either sewer or. water individually is $20.00 plus
$ .50 surcharge. ' ,
* Sewer and water permits issued, for new construction must be
J ~:Ci~~~d~~~~n~im~c~t~i~e~:~d :~dth:a~~~e ~~rmt~~ua~~:
",dk~rOATE~,::~:d ~ JUL 29 2004. I . AMOUNT P~ ~~j'j').j
,.:.>'t;;,?;'., RECEIPT .# J.. REC'DBY - ,'<~ii ~~~";'0"
\'0':":"";"';' : ' lti y - ,,- J ". '-
;.';," .
,I
. . .:;,.1
"':h,;~;':;.',, " ,
';"'~".16200Ea81~:.Creek Av. S.E.. Prior Lake. Minnesota 55372/ Ph. (,~2) 447-4230 I FAX (9$2) 447-4245
An Equal Opportunity Employer
;952 894 0925
# 8/ 9
Date Rec'd
CITY Uji' J:'KIUK LAK~
HEA TING/AIR CONDITIONING/FlREPLACE PERMIT
I. Pink
2, Gretll
], Yellow
File 'f- 70
City, I PERMIT NOnA. ^ '1~, [L,i
Applicant v-f"" ~::;J 1~
~f2'Ti
(Please type or print and sign at bottom)
ADDRESS
Ll~' -7C) MJ( I(?; His '-T((l,("~{
ZONING (office use) I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
Pill
I
&~e~R "11Ai;;/c:' fJO(iULY
(Address) gL'5 IfhfhU)(JJ jfh ~9f.{.,(jQ..f /-
(J
if / LIO
(phone) {a\-j - LI52S'ZOO
f.LU:.(j/7 /J7/7 55/2J
(
APPLICANT
eN ame)
(Address)
rL.'ffflVr;lc Ill;;dlillY & i-\iC, LLl,
12481 Rhode Island Ave. So.
- - - -
':'Cl'cyt::, JVI(J'-d~o-'II~~
(phone) q"") (") - gq (./- ()(X)s
::;;.:;;.,
\Wk
(~>>
(City)
(Zip Code)
:~):;.,:.
(Contact Person)
APPLICANT SIGNATURE (i)-2f) ~
(Phone) .
J3l\MrYJ7G./J
DATE
Jd- dd-OY
APPLICANT PLEASE COMPLETE BELOW
I:XJNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS ,
FURNACE MAKE AND MODEL IQj 7..LJOY' G t..j ~ :JLI.:5..()(/- S- FUEL j](CfCd7i.A j
FLUE SIZE RETURNOPENINGS t/-O?1fc:s INPUT if-vol':5 OUTPUT V,,'-/r;{)
, , ,
TYPEOF SYSTEM HEA'ffiITG: OR. POWER PLANT
Industrial, Commercial & Multi-Family
O~E SCHE})UL,E
1 %of job cost ' 'Residential, Gas Fireplace
$39.50 minimum '
$99.50 Residential, Additions & Alterations
$64,50 Residential, AC Only
$~9.s0
$39.50
$39.50
I
I
I~
l'~i
QWarmA,ir Plants
OGflwity .'
blMechanical
~irC~~ditioning
OVent. System
O~team
DlIotWater
o Rlsdilltion
o Special Devices
o Other Devices
'~HE:~~~~(:)*:
~ir~(.lncJj~(l~~rLTnits
q~()tgm:r9~ch into
RequireqSide Yard'
Setbacks
FIREPLACE MAKE AND MODEL
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Penn it #
~
..~ --Wuh
.;;~e.T'-fl:r;t!!!lcflt, ..
",-".- ...., -. .
(OOice Use Only) >
. i. ',':; ,':;..~;:"'~'.:.. .:~.::~ '"~
'l'~isApplic8tion:IJtc()~~Y()urJJ#~i~i~~~~r~~~W##K~~~t().y~# ...'.,. ',/:.,t8j4.'..>,..'...,.,.
:";,,.",:."':":"'
',', '...lf~~!0i~~~9.< ,".
~y
Building Official
Date
Da~EC. 2 7 2004
24 hour notice for aU inspections (952) 447.9~~,t~K~~~~~~1-424S
16200 Eagle Creek Avenue, Prior ~1I~MN~?~72..' ','
. .'.,
PRIOR LAKE DEPARTMENT OF Main File
BtdlLDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS J.f87tJ _ -aLl/Fr' H6/(i Hrs rUI',
NATURE OF WORK N!6t-t:J ClJftJ~1 "fl,l,cc:'CKJ~
USE OF BUILDING S, F': A ·
PERMIT NO. ~A4-,07S4-- DATEISSUED ?/J,/tJl/
CONTRACTOR ,dt.rt NIIMes p~-ZZ/-C("1'S
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTO" DAJE / /I
I FOOTING I mJ! I ff:I,IJlPt
I FOUNDATION (Prior to Backfill) t7t'A.,J,tI //-U4 //r'~~ I ,J:,,!,tU1
PLACE NO CONCRETE/UNTIL ABOVE HAS BEEN 'SIGNEb
ROUGH - INS
SEWER I WATER I SEPTIC 4(t '1 (Jt1ft. r 1.(--;-- ~- 1tJ-fl1
FRAMING. m", ~. / I /tJ ~
INSULATION ~~ /,b~-
ELECTRiCAL.... . , / / ~/o.~
PLUMBING // (;. IItrI '1/et/rf 11t-tt- ;, / fl',~ 4, \"
HEATING (if required) 47'4 / py/oS-
FIREPLACE. . ,
GASLlNEAIRTEST~k. '7l/f4~/ ~ #ftJ--
/ /
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
11//5
/lfs-.
J ·
GRADING (Prior to Sodding)
BUILDING 1-<N1? {-I -lj 5
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
/ /) ( :><1 "s.r-
J/ (I v.f
J
fJ{If
$"~ ~, /<'S-
UNTIL ABOVE HAS BEEN SIGNED
NOTICE
)/~/!~\{:
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet Is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
@erfifitafe of Q1}ttupantu
CITY OF PRIOR LAKE
~tparftutuf llf ~uil~iug JluSptrfillu
I
f Final Permitted 0 Conditional e.O. Expires .
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code certifying
that at the time of issuance this structure was in compliance with the various ordinances of the City of Prior
Lake regulating building construction or use, For the following:
Occupancy Type
R3
Type Construction
VN
Fire Zone
Bldg, Permit No.
N/A
c 4-, { 754-
pun
Use Classification
SINGLE FAMILY
Zoning District
Legal Description
L52, Bl, TIMBER CREST PARK
Owner of Building
Site Address
4870 BLUFF HEIGHTS TRAIL SE
Contractor's Name & AddressPUL TE HO"1ES, ~. NORTHWEST PKWY., SUITE ] 40,
ROBERT D. HUTCHINS /:)%2--: _ City Planner. nON RYE
Building Official
Date: 1/ , / t ('" Date:
EAGAN
551:21
DATE TIME
SCHEDULED ~~
gt f)/J ~- 7//
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
t/J' 70
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
~CH FINAL
~- 7S-~
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
.......:.... u~SLlNE AIR TST
o
COMMENTS:
.,..4 / / /
/&~~.fH"le hr- /i 0-'5 r- 0"-
~e;;,rff~- JO S- ~;'h; ~./'/'J
--:;-1- /k-:;e;- / .
/
~c e~ Ut f ()rS"'f I-
~ /
hh4-/
/
/'
UtC
/
7~ur
~WORK SATISFACTORY, PROCEED
/0 \ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL F~.?INSPECTION BEFORE COVERING
Inspector: ~_~-(;;:ner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TIME
CITY OF PRIOR LAKE ,.., /.. ,~/
INSPECTION NOTICE SCHEDULED k~ 05 -
~'7t? <Lf/-;/p A- ///
>--- ,
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~ 7S-Y
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
~BING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
/1J /"
/;P'/eno~e (~,-
~/
~r
/
Ale
~ /
/[h"7' /
/
/'
/'") K
----
{;7 AJcc!' ~ / t:/ / ft:.r-h/~cJ/
o WORK SATISFACTORY, PROCEED
AORRECT ACTION AND PROCEED
o CORRECT WORK;,. C~Lj y6R REINSPECTION BEFORE COVERING
Inspector: /i'~ Owner/Contr:
~
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INS/Ion
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED IO-J'I-oJ
ADDRESS "1670 Bluf,p. J41J:s Tr I
OWNER CONTR. J O/i-c. t/()~ J
PHONE NO. PERMIT NO. ol/ - 75"'1
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~AnI~~L1NG
o C PLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
6!:Je-AL
tulbilDIo-tPL
f)""'T
Y WORK SATISFACTORY. PROCEED
t CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR 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!
INSIiOTl
DATE TIME
CITY OF PRIOR LAKE '] -).] -OJ-
INSPECTION NOTICE SCHEDULED
ADDRESS t-{ rc7() (]( cJrF I +'fJ
OWNER CONTR.
PHONE NO. PERMIT NO. 4"' 7S"'/
o FOOTING o PLUMBING RI o EXIGRADIFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
J6'FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
0--!f1Vll1t'(.+ a t1U:"-( Pn-/V1A.. 5.v.Aof /7 h
dr-a,j"" I 1/'0 be.( LI( I
o p, ""'(.( ( ~ .~d( CI /,'7/?-"Olrl1 /
dC ) ~ d,2 ,J:., 'i;c -c 1.$ ,
rl ~V1-<p t.Nl 1,1
(-( -0.')--
o W~TISFACTORY. PROCEED
~RRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR 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!
INSNOTI
BUftN~ "I-LLE
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave S, Savage, MN 55378 . 952-894-0005
OI"i4l Test Report for Jobl
Address 1870 &ulf tl(;;,/6(/7S I R. City (p.1()f1 LJ4 K c:
Occupant
Date of Install
Type of HT. F/A ~ HW Space HT Unit HT
Other
Make 1 t: ,vfJDK
Model G4:,u," - :24~- 01.4'5 - DI
Serial 590~C\5S'tp
Input 144 ,ODD ~1,..u1
Pilot Type
Pressure
Input CFH
Stack Temp
HOT SURFACE IGNITOR
3 ") I Lt.)C- C02 f&,.?
L-\ L\ 02 q . q
10?- CO rz.. pP f'('
Date Tested '3 - 4 - 0 s
Company
Technician
BURNSVILLE HEATING & AIR CONDITIONING
!~~- 0