Permits - Permit# 09-14M - 2468 Black Lake Road - 1/1/2009CITY OF SPRING PARK
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4349 Warren Avenue Spring Park, MN 55384
Noise Ordinance In Effect:
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 PEAINIT
3
Weekends/Holidays
before 7 a.m. and after 8 p.m.
Date:
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State Bond No.
as Fitters License No.
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SITE ADDRESS:GK C,Q
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OWNER r ar)( r r
MECHANICAL CONTRACTOR Name / Address / City / State / Zip / Daytime Telephon
I �I,�„�Qh— C 1, 1 t "l' 53y
ESTIMATED VALUE
TYPE OF WORK: A2esidential ❑ Commercial
New Replacement Other
WARM AIR
AIR CONDITIONING SYSTEM
UNDERGROUND DUCT SYSTEM: Yes( ) No
Gravity Forced
Tons L 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/Iocated
WET HEAT
GAS FITTINGS
Baseboard In -Floor
Steam Hot Water
❑ Water Heater ❑ Furnace ❑ Stove ❑ Dryer ❑ Grill
Gross Sq. Ft. Input B.T.U.
❑ Unit Heater ❑ Fireplace ❑
FIREPLACE
No. of Fireplaces
�1
IMechanipl Permit Fee: $ %4
Fuel Type
Gas Fitting Permit Fee: $ 'f'4C&4kyL
State Surcharge: $ .50
Mechanical Com�mee'n�ttss::�
ireclulrad
Total MECHANICAL Permit: $ Sv
gnawre of this application
ca on by the property weer or a licensed contractor, as the oval s representative and authorizes the CityZonlng n rate or s ee one a np a ea to
er upon the property to perform needed Inspections. Entry may be Wthout prior notice. I hereby acknoWedgp that 1 have read this application and state that an infomratbn Is true and correct to the best of rry knoWedpe. I
further apes that all work performed will be In accordance veh approved plans, spec8lcabons and conditions and to abide by all ordinances of the City and the laws of the Sate of k0nnesota regprElnp actions taken pursuant to
is pemit. I agree to pry all plan room fan even If 1 efo not to proceed with the M asptrea when work Is not corrunenced Wth 180 days from date of permit issued, or If building and work Is suspended,
abandoned or not Inspected for 180 days. Work beyond orWlhout a pemah or Inspactlon wbJaet t a perla8y.
SPECT for Inspections at (8 442-7;�(24 Hour 8.00 a.m. -4:30 p.m.
SIGNATURE OF APPLICANT: I eU MVl_ DATE:
PRINTED NAM V.DATE:
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