3579 Blue Jay Way Unit 204City of Eagan
PERMIT
City of Eaan
Permit Type: Mechanical
Permit Number: EA119203
Date Issued: 11/19/2013
Permit Category: ePermit
Site Address: 3579 Blue Jay Way 204
Lot: 272 Block: 04 Addition: Lexington Place 1st
PID: 10-45050-04-272
Use:
Description:
Sub Type: Residential
Work Type: Replace
Description: Furnace
Comments:
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Holly Flood
1408 Northland Dr #310
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:
Yvette M Malinowski
3579 Blue Jay Way Unit 204
Eagan MN 55123--221
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
SEDGWICK HEATING & AIR CONDITIONING CO.
1408 NORTHLAND DRIVE, SUITE 310 • MENDOTA HEIGHTS, MN 55120 • (952) 881-9000
HEATING JOB NO / `
00
TEST REQE)VED
ADDRESS 3C-741 &'r' --"""y ta1 CC �-''Y�7- CITY P.449 JAN 1 2013
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OCCUPANT
SOLD BY
MAKE
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SERIAL NO $ 9 /31J cFc2,Z
THERMOSTAT (.1-4:.(>,-` J6 Y%c>rS,
VALVE (h' -/c oc, �� =5
LIMIT -5;1 u IP
LIMIT SETTING
FAN SETTING C -C
PILOT TYPE ..%
IGNITION MODEL
PILOT TIMING ✓/J�
r V�
PRESSURE`
INPUT CFH CC
STACK TEMP.
FORM 235 (REV. 10/10)
PERCENT CO2 '7 0
PERCENT 02 / " f'
PERCENT CO
OWNER
INSTALLED BY
MODEL L )SFC/ lo V56/1—
INPUT aw/1—
INPUT
VENT SIZE
TYPE OF LINER ci5G `"
LINER SIZE
FILTERS: SIZE /"r A ), 10
WIRING V ,-
TEST TAG
LIGHTING INST. 1' ^ /
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I �'S
NUMBER 1
DATE TESTED /I/ -? o 4-3
COMPANY TESTING C.J
NAME OF TESTER il Z
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FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY - CITY