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Home My WebLink About2016-01515 - gas line only CITY OF ORONO * Z 0 1 6 - PJ 1 5 1 5 * 2750 KELLEY PARKWAY DATE ISSUED: 12/02/2016 � � ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1670 SHADYWOOD RD PIN : 17-117-23-21-0015 LEGAL DESC : SHADY-WOOD : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY VALUATION : $ 500.00 NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. NEW GAS LINE FOR OUTSIDE GENERATOR APPLICANT MECHANICAL 50.00 STATE SURCHARGE MECH(VALUATION) 025 PETERS PLUMBING TOTAL 50.25 20455 MANOR ROAD Payment(s) EXCELSIOR,MN 55331- CREDIT CARD 4025 5025 (612) 803-5066 Minnesota State License#:plbg-PM093027,mech-MB669934 OWNER KIELLEY, DONALD&ARLENE 1670 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 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 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 afrer work has commenced. The applicant is responsible for assuring all required inspections are requested in wnformance with the State Building Code.This permit may be �%�, revoked at any time for due cause. � �� -�.��_��'"_ _ (� �"i—Li� �� , ��, �/ ��." �_.. Appli ' Per i e Signature Date Issued By Signature Date FOR CITY US NLY ,� � • �� City of Orono � � �� !(,�� %��--al O P.O.Box 66 Date Received: Permit# � 2750 Kelley Parkway � ` Crystal Bay,MN 55323 Approved By: Amount$:�� J Phone(952)249-4600 Fax(952)249-4616 � y y � F � lqkfSHO��G CITY OF ORONO—MECHANICAL PERMIT (All Commercial pennits must be approved by the Building Otticial or Inspector and/or Fire Marshall) GENERAL INFORMATION L You may apply for mechanical permits by mail or in person at the Ciry offices. Applications 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 Desiens—Complete calculations,details and specifications are required for each heating,ventilation,humidification-dehumidification,and air conditioning installation including heat loss/heat gain calculation, design temperatures,equipment ratings and identification as to type,manufacturer and model. Data shall be presented on form provided. 4. When any new construction 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 fmal). Call(952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before fmal. TYPE OF PERMIT (Check All That A 1 ) �Residential ❑ Commercial(Approval Required) [Backflow Device: ❑ AVB ❑ PVB] �New ❑Additional ❑ Repairs ❑Replace � Job Site/ Owner Information: Site Address: /� 7D' S'��y wOd'0 ,�k--�� Owner: �� '�� MailingAddress: � 6�� 5�� City: D�Nt� Zip: SS �� Home Phone: 95�Z^ �� d 6 � Alternate Phone: Contractor Infonnation: Contractor: ��5 ��G Contact Person: ��'� ��%�2s Address: �4� �'�d'G� State Bond #: �G l'¢� 2� Clty: ��G�'S'd� Zip: $S33/ Expiration Date: ��7 Phone: �/Z�� b 6 Alternate Phone: �— � Insurance —Current: � ��'�'�'� 1 MECHANICAL SYSTEMS BEING INSTALLED • Note: All Geothennal 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: 2`� '�' Output BTUs: 1 i CFM: � COOLING SYSTEMS � Quantity: Make: Model: Tons: i H. Power FIREPLACES ❑ Gas Factory Fireplace Brand Name: ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: � ❑ Wood Stove with Flue/Masonry VENTILATION i ❑ No. Kitchen Exhaust duct recirculating cfin ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon ta�1k in place.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside �'r LP Gas: gallons Other: GAS LINE ONLY �vT��Q� ❑ Outdoor Grill � Other/List What&Where: ��?�/Q' 2 1. CONTRACT PRICE * is 1.25%of c ntract 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 fumished 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. , ��G� 2,2_�,� Applicant s Signature: Date: � 3 � � ��j�� DAT TIME CITY OF ORONO cnLLED IN INSPECTION NOTICE scH�uLED PERMfT NO. �..L(��5�� co LETED ADDRESS � � � �� -�C3 OWNER TELE O E NO. � l0 CONTRACTOR �-�� "� � 2� ; / % '�l.l � DESCRI'PTION 41 ❑ FOOTING � DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL 2 ❑ RADON SLAB ❑.MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING �MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATEH HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ ❑ DEMO-SITE ❑ SEPTIC�ALL v i OWNERICOf�ITRACTOR TO MEET YiOU:_YES ` NO � COMMENTS: ` � �� r�'tri�� rc?5'i..�ctvt/— 4 �� 4t��i,S�e. . 0 A�'Y�U��i^Ou ncQ — ,�b�vl�"6 — $d a�'J LLc,S�`c�,��- '� � !�.•�,� ��r ��,� , .o�, ,-�,�� -- � 0 QR�s� o f r��,� ��„w�lp�e -�— i �/��rs �� GOri(' �� ✓n��' -��rl�lc� W ❑WOFiK SATISFACTORY:PROCEED �ECT COMPLEfE � CORRECT WORK 3 PROCEED ❑I E CERTIFlCATE OF OCCUPANCY W O ❑ ECT NfORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CONERINf3 PERMANENT ❑CORRECT UNSAFE CONDITION WRHIN HOURS. p pH0T0 TAKEN INSPECTOR WFLL RETURN ❑5TOP ORDEH POSTED.CALL INSPECTOR ��TATION ISSUED ❑INSPECTION REUUIRED.CALL TO ARRANGE ACCESS. Call for the next Mspection 24 hours in advance. (952) 249-4600 Owr�erlContractor on site• Inspector: �-�- �� . � ✓: Whib CoVYAnsp�cto�'s Flle C�nary CopplSit�No4iex