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2220 White Water WaySEDGWICK HEATING & AIR CONDITIONING CO. 1408 NORTHLAND DRIVE, SUITE 310 • MENDOTA HEIGHTS, MN 55120 • (952) 881-9000 HEATING TEST RECORD JOB NO 5 ` / a�- ADDRESS Rao WAM- -1044e,- adityCITY C�% � OCCUPANT OWNER ` ab � 9+ c/ SOLD BY //� . INSTALLED BY MAKE q % / MODEL i✓©GD.D V SERIAL NO c (/ 2 �6 ` 330 t INPUT 16,190 ✓ 6 ���I� ED THERMOSTAT VALVE LIMIT LIMIT SETTING FAN SETTING PILOT TYPE Will`{ y.err - Sna/goorrcovtp VENT SIZE 4111 TYPE OF LINER c/( LINER SIZE FEB 2 2 200z FILTERS- SIZE WIRING TEST TAG /( 2-,✓ [ NUMBER - ree G ML IGNITION MODEL N LIGHTING INST �/ PILOT TIMING / ' / DATE TESTED Z/ "'% /( PRESSURE ' S PERCENT CO2 5 / COMPANY TESTING ✓� . INPUT CFH PERCENT 02 /J� STACK TEMP. PERCENT CO D NAME OF TESTER ,a' Z ' 1 FORM 235 (REV. 10/10) FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY - CITY City of Eagan Eagan, PERMIT City of Eaan Permit Type: Mechanical Permit Number: EA102964 Date Issued: 02/08/2012 Permit Category: ePermit Site Address: 2220 White Water Way Lot: 605 Block: 04 Addition: Eagan Heights Townhomes 2nd PID: 10-22426-04-605 Use: Description: Sub Type: e - Furnace & Air Conditioner Work Type: New Description: Furnace & Air Conditioner Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952) 445-2840 Fee Summary: ME - Permit Fee (Replacements) $55.00 Surcharge -Fixed $5.00 0801.4088 9001.2195 Total: $60.00 Contractor: Sedgwick Heating & Air Conditioning 1408 Northland Drive, Suite 310 Mendota Heights MN 55120 (952) 881-9000 - Applicant - Owner: Todd J Johnson 2220 White Water Way Eagan MN 55122 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature