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Home My WebLink About2012-01228 - gas line only ` �� CITY OF ORONO * 2 0 1 z - 0 1 z z s * 2750 KELLEY PARKWAY DATE ISSUED: 12/06/2012 ORONO, MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 2900 DEER RUN TR PIN : 04-117-23-24-0013 LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN : LOT 008 BLOCK 004 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY . VALUATION : $ 1,300.00 NOTE: GAS LINE TO POOL HEATER 250,000 BTU APPLICANT MECHANICAL 50.00 METRO GAS INSTALLERS STATE SURCHARGE MECH(VALUATION) 0.65 685 141ST LANE NW TOTAL 50.65 ANDOVER,MN 55304 (763)754-7119 OWNER KACZKE,ROBERT&JILL 2900 DEER RUN TR LONG LAKE,MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if consWction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are • requested in conformance with the State uilding Code.This permit may be revoked at any t' f due cause. �J / / � Applic ermitee Signatu Date Issued By S' ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED ABOV . 1 �� • , FQR'GiTYUSE i�NL� O,¢O�O City of Orono � > P.O.Box 66 �atB�Re��t�: °° "'� Petm�t� 2750 Kelley Parkway '�� y� Crysta]Bay,MN 55323 Apprn�et��i,y Anxjunt$ �� Phone(952)249-4600 Fax(952)249-4616 e CITY OF ORONO—MECHANICAL PERMIT (All Commercial permiu must be approved by the Building Official or Inspector and/or Fire Marshal]) GEN'EI�AL TN�OR1k1P,T'T�I�t 1. You may apply for mechanical permits by mail or in person at the City offices. Applicarions will be reviewed and a permit will be issued within two working days. 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desig�ns—Complete calcularions,details and specifications are required for each heating,ventilation,humidification-dehumidification,and air conditioning installarion including heat loss/heat gain calculation,design temperatures,equipment ratings and idenrification as to type,manufacturer and model. Data shall be presented on form provided. 4. When any new construcrion or remodeling is involved,a separate building permit must be obtained. 5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code requirements. 6. All work must be inspected(rough-in and final). Call(952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before final. T�E..C?�P�R1V:[ITp ' C��A�l�':��rat A 1� } �Residential ❑Commercial(Approval Required) � New ❑Additional ❑Repairs ❑Replace .��?�i��I"�.el".T11f�a�rTrila`h�ri: � I Site Address: . � Owner: �L Mailing Address: / � City: /�G'� Zip: Home Phone: (.��—�(� /J �� Alternate Phone: Co�tz�.ac��r,.It�orma�ior�: : Contractor: � Contact Person: � �///S / /�/ Sf , / Address: (y //� ��'V State Bond#: City: �� Zi • ,30�Expiration Date: Phone: — J ' �I / Alternate Phone: � ` /� �� ❑ Insurance—Current: 1 ti. , . i„ Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. IS THIS GEOTHERMAL? ❑ Yes ❑No HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: Input BTUs: Output BTUs: CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: H.Power FIItEPLACES ❑ Gas Factory Fireplace Brand Name: ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTILATION ❑ No. Kitchen Exhaust duct recirculating cfin ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FL1EL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑Inside ❑ Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill Other/List What&Where: �Z ,S� OD�� l�' � � 2 � c ❑ Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: 1. Does not require modificarion to electrical or gas service. 2. Has a total cost of$500.00 or less;excludins the cost of the fixture or appliance:and 3. Is improved,installed or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Pernut $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ If above does not apply;follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) x.0125$ (contract price) (minimum$50.00) 2. STATE SURCHARGE x.0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials,labor,profit, and other fixed costs. It is the amount to be charged to the customer for the work done. If any material, equipment, labor or installations are fiunished by the owner, tenant or any other party, the reasonable market value of such items must be added to the estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may request the submission of a signed copy of the actual contract. The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all . work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements made on this application are complete, true and correct. Applicant's Signature: � � Date: �� 3 5� AT TIME v CITY OF ORONO CALLED IN �� INSPECTION OTICE SCHEDULED _/2-�-/2. �3=� PERMIT NO.��z- � �� COMPLETED ADDRESS Z�� e�r �� OWNER TELE HONE N0. �"�z �3� `3�� CONTRACTOR ��r� ��-S ��5��r,� >; DESCRIPTION �� '� �� S�" � lV ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FIL�ING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS h Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � �.-.. A ,��+ � �e— i �l l,hJ � � ` � W � Q � Z W � W � � GW �VORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CAII INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContractor on site: Inspector. 1' � �.'�-. �� , :.� -�. White Copyllnspector's File Canary Copy/Site Notice