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CITY OF ORONO 11111011101 11111111 <br /> 2 * <br /> 2750 KELLEY PARKWAY * 2 00 1 4 — 0 1 4 3 2 <br /> DATE ISSUED: 12/15/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1000 OLD CRYSTAL BAY RD S <br /> PIN : 09-117-23-11-0009 <br /> LEGAL DESC : FRENCH LAKE OF ORONO 2ND ADDN <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 4,000.00 <br /> NOTE: (1)NATURAL GAS FURNACE <br /> MODEL-VSPH120 <br /> 6"FLUE <br /> 120,000 INPUT BTU'S <br /> 100,000 OUTPUT BTU'S <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 2.00 <br /> TEAM MECHANICAL INC. MAIL-IN FEE 2.00 <br /> 3508 SNELLING AVENUE <br /> MINNEAPOLIS,MN 55406- TOTAL 54.00 <br /> (612)729-5646 Payment(s) <br /> Minnesota State License#:mech-MB003782 CHECK 21196 54.00 <br /> OWNER <br /> FULLERTON,MARNA <br /> 1000 OLD CRYSTAL BAY RD S <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This pe it may be <br /> revoked at any time for due cause. <br /> 15 e _ a. ,15 <br /> Applicant Permitee ' Date Issue By Signature Date <br />