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•_ � � � FOB�CITY USE O�'LY <br /> �O�O City of Oro�ECEIVED p.� � <br /> P.O.Box 66 Datc Receivcd: Pern�it# Q�Q/�(/U <br /> 2750 Kelley Park��a� <br /> Crystal Bay,MN��}��3� � ��'��% Approved By: Amount�:__�`�_ <br /> Phone(952)249�04� �x(9�5 _�9-4616 <br /> .d �. <br /> `� <br /> y`� �' {���"'�NNO— MECHANICAL PERMIT <br /> 19kEs�0�`�` <br /> ,� _� (All Commercial permits must be nppro��ed hy the Buildin�Ofticial or lnspector ancUor Fire Marshall) <br /> GENERAL INFORMATION <br /> L You may apply for mechanical permits by mail or in person at the City offices. Applications will <br /> be reviewed and a permit will be issued within two working days. <br /> 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT <br /> VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST:VOT BEGIN UNTIL THE <br /> PERMIT CARD IS POSTED ON THE JOB SITE. <br /> 3. Mechanical Designs—Complete calculations,details and specifications are required for each <br /> heating,ventilation,humidification-dehumidification,and air conditioning installation including <br /> heat loss/heat gain ealculation,design temperatures,equipment ratings and identification as to <br /> type,manufacturer and model. Data shall be presented on fonn provided. <br /> 4. When any new construction or remodeling is involved,a separate building permit must be <br /> obtained. <br /> 5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code <br /> requirements. <br /> 6. All work must be inspected(rough-in and final). Call(952)249-4600. <br /> (24-48 hour notice required) <br /> 7. House Heating Test Record must bc submitted before fina(. <br /> TYPE OF PERMIT � <br /> � (Check All That Apply) <br /> �Residential ❑ Commercial (Approval Required) [Backflow Device: ❑ AVB ❑ PVB] <br /> ❑ New ❑Additional ❑ Repairs �'Replace <br /> Job Site/Owner lnfornlation: <br /> Site Address: f c� C i � ��T(�iT�.�% �-�," <br /> { <br /> Owner:�l�Gi�/(=' �T y., ���'�..��,;,;` Mailing Address: �-;t S'f� (-�E . <br /> r-. <br /> City: ( ,��',��d-.z____r„ Zip: �� <?�'j <br /> Home Phone: ��/o.� — J ri) c�yC!�lternate Phone: <br /> Contractor Informatian: <br /> �.. <br /> � � r <br /> Contractor: H��j , r- �,� Contact Person: I " <br /> Address: (�� ?j - �t���` i� C;J't�State Bond#: j�f���G�.S��;�� <br /> City: Zip: `�S�, �� Expiration Date: ��0�''_ <br /> Phone: ���� - �����<)�1 :� Alternate Phone: <br /> , <br /> Q Insurance—Current: �" ? '� �� <br /> 1 <br />