Permits - Permit# SP13-01 - 2468 Black Lake Road - 1/1/2013CITY OF SPRING PARK
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4349 Warren Avenue Spring Park, MN 55384
Noise Ordinance In Effect:
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Phone (952) 471-9051 Fax (952) 471-9160
Monday - Friday
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before 7 a.m. and after 10 p.m.
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MECHANICAL PERMIT
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Weekends/Holidays
before 7 a.m. and after 8 p.m.
Date: ( /,3
State Bond No.
Gas Fitters License No.
SITE AD ESS: o?"/leg lack L4ke 9,k
OWNER M; ke k",4 (Sp�`ns �.�anhnn
MECHANICAL CONTRACTOR Name / Address L 48M/ f� LTd l Te, INC. R hi & li
ESTIMATED VALUE
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Lic. BC0512060
2700 Fi
TYPE OF WORK: Residential ❑
IRV W QV
Commercial ROSE
ILLf?!M=11 eplacement Other
WARM AIR 6
51.633.2561 AIR CONDITIONING SYSTEM
UNDERGROUND DUCT SYSTEM: Yes ( ) No ( )
Gravity Forced
Tons CFM Ductwork
Input B.T.U. Output B.T.U.
VENTILATION / AIR EXCHANGE
Exhaust Only Air Exchange Unit
No. of Fans Size Type Type -Mixing Box
Heat Recovery Ventilation
C.F.M. Del Static Pressure Recovery Efficiency Net Air Flows
Where ventilation is used/located
WET HEAT
GAS FITTINGS
Baseboard In -Floor
Steam Hot Water
o Water Heater ❑ Furnace ❑ Stove ❑ Dryer ❑ Grill
Gross Sq. Ft. Input B.T.U.
o Unit Heater Fireplace ❑
FIREPLACE
No. of Fireplaces
Mechanical Permit Fee: $
Fuel Type
Gas Fitting Permit Fee: $
Mechanical Comments:(Dr-S liro—
State Surcharge: $
$
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$
Total MECHANICAL Permit: $
Signeture of this application by the legal property owner or a licensed contractor, as the owner's representative is required and authorizea the City Zoning Administrator or designee and the City BWldng official or design
enter upon the property to perform needed inspections. Entry may be without prior notice. I hereby acknowledge that I have reed this application and state that ell information Is We and correct to the best of my knowled le
further agree that all work performed will be in accordance with approved plans, specifications and condbons and to abide by all ordinances of the City and the laws of the State of Minnesota regarding actions taken pun ui
to this permit. I agree to pay all plan review fees even If I choose not to proceed with the worRermit expires when work Is not commenced with 150 days from date of permit issued, or if building and work is
suspended, abandoned or not Inspected for 180 days. Work beyond or witho.rt a permit or inspect -on will be wbiecl to a penalty.
Call MNSPECT for Inspections at (952) 442-7620. (24 Hour Notice) 8:00 a.m. - 4:30 p.m.
SIGNATURE OF APPLICANT: DATE: / 7 b 3
PRINTED NAME: xo»syi' fir;& 6" to DATE:
For All Rough -In And Final Inspections Call MNSPECT At (952) 442-7520 (24 Hour Notice)
Gas Line Air Tests Required
Poor Quality Document
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times a QUALIFXING BUILDER and the c ' 'e''tiold�ta�de'>30mplianceit a required general
liability insurance, and workers'
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UC Number BC5120
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Effective Date.
ExpirationExpirationDate OWW20i3l -0ofI W AVE-)OLLE, MN 55113 M. L
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