HomeMy WebLinkAboutMechanical 07-0055
DATE TIME
CITY OF PRIOR LAKE $/trr '1 : 00
INSPECTION NOTICE SCHEDULED
,..
I ~
ADDRESS 6930 ~j
OWNER CONTR.
PHONE NO. PERMIT NO. 07- '5s-
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION ((i). 0 SEWER HOOKUP
o FINAL 1 0 PLUMBING FINAL
o SITE INSPECTlO ')il:. MECH FINAL
COMMENTS: ~- ,:_ 0 , ~
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
Iff) /J
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r
I .
tLQj
1\
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P!WORKSATISFACTORV. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~ 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
SERIAL NO.
516 /..; ~/'1 /vo-,
'J rg-OOU
THERMOSTAT i. ~ .~ _ IY)'
VAlV~ ~"'4,w-(A7
LIMIT ~
LIMIT SETTINf cJ (;) D ..-30 rPp
~( .""l *..J
()~
IGNITION MODEL ~ l
PllOTTIMING )< S ILu9 ~ - ,
- v/ ~ CfJ/t?
PRESSURE ~ .(:::, {< 0/' PERCENT CO2, ('), 'c
INPUT CFH . q (J PERCENT O2 _ l.Q %
STACK TEMP. S1p .r PERCENT CO _ 'I'
FAN SETTING
PilOT TYPE
FORM 235 (REV. 11/89)
HEATING
TEST RECORD
VENT SIZE
tsJ
TYPE OF LINER
LINER S17'"
! 1_t.J X d5:
FilTERS: SIZE
WIRING
.-
TEST TAG _
LIGHTING INST.
DATETEST",n ;I ~~ ~~'f7
f <:? f .'
COMPANY TESTING ~,I' m
NAME OF TESTER_ ~~ ff#
FORM DISTRIBUTION: W';E toP~ . JOB FILE
JOB No.Sf 6 3 'I
I "'l I I
NUMBER _ f '\ DD
.-..;
YELLOW COPY - CITY
t) ":) 8 \0'3 ~
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
I "; G!C 7
I. Pink
2. Green
3. Yellow
~!~ I PERMIT NO'07 U/15r-t
Apphcant ' U ..:::> I
(Please type or print and si~ at bottom)
ADDRESS
S~ 3D (Y\L I \-e..,.r ~ LA.-r- ~ C
ZONING (office
use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID .) \. (j (t. 0 u 3 0
OWNER,
(Name) _ Do---u (d u I d ~ b lA..-V j
(Phone) '152 '1 '-(j - '6/11
(Address) '5C) 3 0 ('v1 L I \ vy 5 l.A..' ( 'Sf'
APPLICANT
(Name)
(Address)
SEr,GWICK HEATiNG & AiR CONDITIONING lLC
8910 Wentworth Ave.
Minne~polis. MN 55420
(Ad~) !:stI1 .9000
(Phone)
(City)
(Zip Code)
(Contact Person) ,,(Phone)
APPLICANT SIGNATURE ,\TZvvvt~S=l~\AA t).C_tA.{? DATE \ I Ii (DJ
. APPLICANT PL~E COMPLETE BELOW
DNEW CONSTRUCTION N'REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL ~ (l o)c 6 bOlA. \-t 3\0 B () 0, 0 FUEL (};;ecs
FLUE SIZE RETURN OPENINGS INPUT q Q; DOC) OUTPUT ') 2, ODD
TYPE OF SYSTEM HEATING OR POWER PLANT
fflrann Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
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 & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
--(Office Use Only)
Estimated Cost $ SOla "l . 0 0
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
I
Building Permit #
$ '39."'50
$ .50
$ YD. 00
Buildinl! Official
Date
Paid.l)-o. f/ U
I Date /. 3 v. (; 7
Recei~~ No. 5 Z 8 4--71
By-/
/.
(/
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245