HomeMy WebLinkAboutMech Permit 06-0132
JJ-
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1_ Pink
2. Green
3, Yellow
~i~y I PERMIT NO. /)/ -/3;L..,
Apphcant <--w ~ I
(Please type or print and sign at bottom)
ADDRESS
/&/4a
III ~
. ~ u
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT I BLOCK:.:t ADDITION &~-r
OWNER Ii Ii!z (---:l.':
(Name) VIZ '/11/ lj///~
~"'~
Cf Jl/<lj~ 0 E:
/3;1{}of~ , ..
BL l ?lilt/) ,~Yd PIDd7- /~1"O(J7{)
(Phone) 1~ .~4cJ.. -I hR7
(Address)
APPLICANT
(Name)
(Phone)
SfUuWICK HEATING & AIR CONDITIONING LLC
8910 Wentworth A.ve.
Minneapdlt;~ 55420 (City) (Zip Code)
(Contact Person) (952) ~1-9000;J (Phone)
APPLICANT SIGNATURJf--"'"~A 13~~ DATE ofIj ?/.?i~
APPLICANT PLEAS COMPLETE BELOW
DNEW CONST~CTION I0'REPLACEMENT D AL TERA TIONS
FURNACEMAKEANDMODELc:y~ d'-lIJLt'PJ.?/JtJ'70 FUEL ddd
FLUE SIZE ~ I{ RETURN OPENINGS INPUT OMUT
TYPE OF SYSTEM HEATING OR POWER PLANT
~rm Air Plants D Steam
Q0Pvity D Hot Water
" .......JI. [g1\1echanical t/ D Radiation
c:x.L/rV?U~ ~ir Conditioning -d.kJ.....+m D Special Devices
DVent. System D Other Devices
(Address)
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 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & A/C (New Construction)
Residential, Heating Only (New Construction)
$39,50
$39.50
Estimated Cost $
Building Pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
-iC;.Sb
. .50
4tJ .lJ[}
ffice Use Only)
Building Official
Date
Paid L.f 0 _ ~,. Receipt No.> C / .---'
,Pj ():...; COO
Date:3 '3- 0 By
Cd
U-
Chis 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 /" /? t)
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
rZ~&
/ /
h~/~h 7r1
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PJJlMBING FINAL
~ECH FINAL
TIME
6' -/J.2
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
//
r~/C_
/
COMMEN"(S: I
~-4C-t:. ~ kJr/Pi'ce
/ ./
.~edLe d Or,~q r
/k
t0~, 6:)~;~
//
#/C
'lj.L'
,
O~
,;
4/740 Y /'
?~'~/e' d
~ /
r-/ fi~ /
-
7;(<\ ~
uA-
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO,.m?R REINSPECTION BEFORE COVERING
Inspector: H~ Owner/Contr:
r ,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
SEDGWICK HEATING & AIR CONDITIONING CO.
8910 WENTWORTH AVENUE SOUTH. MINNEAPOLIS, MN 55420 . (952) 881-9000
ADDRESSl&/10 Fy{/t.Jc.J~ T (lA1~{ ,st:::
OCCUPANT _
<)'~
Ilff'1 r;_
SOLD BY
MAKE -L <- Y7 /(,QX..
SERIAL NO,. S-1 () G. e ! y .) l; S
THERMOSTAT /i~ 3& -~
::,:' ~ - ==-.
t de tl,- 7'0 &f-'~
LIMIT SETTING - -.J.
/. /
FAN SETTING _-1' I",~
PilOT TYPE f"J.p.,,<--I
IGNITION MODEL ~/A I
PilOT TIMING S( Si L--'lnA
PRESSURE 3, 5{fCw", PERCENT C02~~-=-~-~-"
INPUT CFH '70 _ PERCENT O2 /.s;, )I c>
] a ., )
STACK TEMP, c- / & "-p. PERCENT CO (.;
FORM 235 (REV, 11/89)
HEATING
TEST RECORD
-/ J... C;
JOB NO, S <0 {
eITY_ PrJ'or Lc,.~
OWNER' ~ f~~.-s-o~
INSTAL.LED BY -7~ /lJ1htY .;? /;J ,'nf. /(tL.-;;'1a r/
/' ,
MODElbCfOUlf3C, ~c)7(~
INPUT ttJGbOO
L\II
~q-
l . I
LINER SIZE _ ~___
FilTERS SIZE _r~ '/. J~ y... L
VENT S17<=
TYPE OF L,INER
WIRING
TEST TAG
LIGHTING INST
DATE TESTED ;)/t:? 7 Ie) [P
/ /
COMPANY TESTING ,) (l &iP1c- k"
~~
NAME OF TESTER ---L ./
NUMBER
;) ~\lAl\ Ie <:.
-
YELLOW COPY. CITY