The URL can be used to link to this page

Home My WebLink About2013-01141 - mechanical ' � CITY OF ORONO 2750 KELLEY PARKWAY * 2 0 1 3 - 0 1 1 4 1 * DATE ISSUED: 10/25/2013 ORONO,MN 55356- (952) 249-4600 FAX: (952)249-4616 ADDRESS : 1650 SHADYWOOD RD PIN ; 17-117-23-21-0014 LEGAL DESC : SHADY-WOOD : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : MECHANICAL-MULTIPLE VALUATION : $ 7,000.00 NOTE: (1)BOILER-SLANT/FIN-MODEL LYNX95-NATURAL GAS APPLICANT MECHANICAL 87.50 COUNTRYSIDE SERVICES 6511 HWY 12 STATE SURCHARGE MECH(VALUATION) 3.50 MAPLE PLAIN,MN 55359 MAIL-IN FEE 2.00 (763)479-1600 TOTAL 93.00 OWNER KREISLER,JERROLD&BARBARA 1650 SHADYWOOD RD WAYZATA,MN 55391- 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 sepazate 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 nuli and void if construction 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 aze requested in conformance with the State Building Code.This permit may be revoked at any time for due ca se. � �o� d �v� z� � � Applicant e 'ee Signa ure Date ssu By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. From:COUNTRYSIDE HEATING & COOLING 763 479 2518 10/25l2013 09:15 #837 P.001/003 P�le � �ri�a � j� '�'�''�6-- '7� , �l74. 9600, � F USE ONLY O City of Orono !/ � �O P.O.Box 66 Date ReC�aved. • Pam�t#��,`,.�� 2750 Kelky Parkway Crys1e1 Bay,MN 55323 Appmv.ed By; A�uoopt. Phone(952)249-4600 Fax(952)249-4616 � '� " y� � � CITY OF ORONO-MECHANICAL PERMTT ��KFSH04� (All Commercial permits must be approved by the Buiiding Official or lnspector end/or Fire Marshall) GENERAL INFORMATTON ]. You may apply for mechanical permits by mai]or in person at the City offices. Applications will be reviewed and a permit witl be issued within two working days. 2. Permit cards wiil be sent by retum mail after a review is completed. PBRMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMTI'. R'ORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanacal Desisn5—Compiete calculations,detaiis and specifications are required for each heating,ventilation,humid'zfication-dehnmidification,and air conditioning installation including heat loss/heat gain calculation,design temperatwes,equipment ratings and identification as to type,manufacturer and model. Data shall be presented on form provided. 4. When any new cons[ruction 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. Alt work must be inspected(rough-in and final). Call(952)249-4600. (Z4-48 hour notice required) 7. House Heating Test Record must be submitted before final. ` ' TYPE O��E3tivIIT ` Check All.`•T�at A:'" 1 �Residential ❑Commercial(Approvat Required) ❑New ❑Additional ❑Repairs �Replace Job Site/Owner 3nformation:. . Site Address: 'I�� 4( �''A Owne� � �l1�t _ Mailing Address: I G 5� W90� i�-U' . c�ry: ��nQ z�p: 5�39/ Home Phone:1� �70 �0'�J Alternate Phone: . ;Contractor Informat�on: 1 � Contractor: ��4��J�1'Va� Contact Person: �� Address: 65�� 1� State Band#: M r-� ��3 �� City: ��t I�R Il'1 Zip:�� Expiration Date: �D �Q �� Phone: �63.y?9 �s� Alternate Phone: 76 g , �{7q, �02 Y ❑ Insurance—Current: ��4�f"/l�T�� 1 N1 Wcr�2Do27�.`� Frem:COUNTRYSIDE HEATING & COOLING 763 479 2518 10/25/2013 09;16 #837 P.002/003 �'�}� � e4�^.b a BJ.d' q. .�� :�:�k _ Note:All Geothennal Systems will now require a Site Plan&Review by our Building O�cial. IS THIS GEOTHERMAL? ❑Yes �No HEATING SYSTEMS Quantity: �.—'06+'1� Make: S CG(M�C �►lil ModeL• _`� Fuel: �_� ^ � Flue Size: �� L/4-. Input BTUs: Q _ Output BTUs: 4`5 �i�i��` �___ CFM: N � COOLII�IG SYSTEMS Quantity: __ _ Make: Model: Tons: H.Power FIREPLACES ❑ Gas Factory Fireplace Brand Name: ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTll.ATION ❑ No. Kitchen Exhaust duct recirculating cfm ❑ No. $ath E�chaust(must have duct outside) cfm ❑ No. Other Fans: Lacations cfm FUE�.STQRAGE (Must be approved by Fire Marshal/if proposing to abandon tank in place.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdooz Grill ❑ Other/List Whai&Where: 2 From:COUNTRYSIDE HEATING & COOLING 763 479 2518 10/25/2013 09:16 #837 P.0031003 ..:y„, . . 3, ' ��!�,�� '-',�" = .�,x��`�,�:"' '� ❑ Yes,this scction applies The repiscement of a Residentiat 6xture or appliance that meets all three of the following requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or]ess;excludine the cost of the fixture or appliance:and 3. ls improved,installed or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicabie) $ 2.00 Total Permit�ee $ �� : � .,ti.p _ �,.�� 1f above does not apply;follow guidelines below: I. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) � Qa0-4X� x .0]25$ �7- ��/ (conuact price) (miAimnm 550.00) 2. S'I'ATE SURCHARGE 2 x.0005 $ o,�, � (contract price) � 3. POSTAGE&HANDLING(Oniy on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE{Add Lines]-3 Above) $ q�� ■ * CONTItACT PRICE or JOB COST means the actual or estimated dollar amount chazged for the permitted work including materials,labor,profit,and other fixed costs. It is the araount to be charged to the customer for the work done. If any material,equipment,labor or installations are furnished by the owner,tenant or any other party,the reasonable mazket value of such items must be added to the estimated cosi or contract price for permit fee putposes. 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. �;n�� .�- _ 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 stateraents made on this application are complete, true and correct. Applicant's Signature: Date: °''�� (� 3 �g ��/ � T TIME � CITY OF ORONO CALLED IN ! �� 3 INSPECTION NOTICE SCHEDULED ��_ PERMIT NO. `"�� COMPLETED ADDRESS lD�C%Sl��--'��a 'L.'GQ--,� ��i � G OWNER �/�/�� /,/��T�LEPHONE NO. �� O'��CS CONTRACTOR � ' �� S � c�� ' ��'� � DESCRIPTION /�� /� �`� ( � � ❑ FOOTING O PLUMBING FINAL ❑ EXCAV/GRADING/FILLING y ❑ POURED WALL ❑ MECHANICAL RI O LAKESHORFJWETLANDS O ❑ FRAMING ICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION OD 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 ❑ SEPTI INAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU: YES_NO y �l: MMENT$: � W � o V e� r ��(�eS N�2c. � -c� f3 Q � �pP� � 0 � W � Q � 2 W � W � j d W� ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W D��iRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN O CITATION ISSUED ❑STOP ORDER POSTED.CALI INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlConVactor on site: Inspector. White Copyllnspector's Ffle Canary CopylSite Notiee