HomeMy WebLinkAbout2018-00485 - mechanical .
CITY OF ORONO * 2 0 1 8 - 0 0 4 8 5 *
2750 KELLEY PARKWAY DATE ISSUED: 04/19/2018
ORONO,MN 55356-
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 1780 SHADYWOOD RD
PIN : 17-117-23-21-0024
LEGAL DESC : SHADY-WOOD
: LOT 019 BLOCK 000
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 10,000.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
(1)BRYANT HEATING SYSTEM
(1)BRYANT COOLING SYSTEM
APPLICANT MECHANICAL 125.00
PRONTO HEATING&AC STATE SURCHARGE MECH(VALUATION) 5.00
7415 CAHILL RD MAIL-IN FEE 2.00
EDINA,MN 55439- TOTAL 132.00
(952)835-7777 Payment(s)
Minnesota State License#:mech-MB004828 CHECK 14666 132.00
OWNER
DIRK ERICKSON ETAL
1780 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 dces
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 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 cause.
� / ( ` /<
Applicant Permitee Signature Date Issued By Si a e Date
s •
FOR CITX i7S�ONLY
O City of Orono `
P.O.Box 66 I)8te itecC�ved: Pettlmit�
� �O 2750 Kelley Parkway
Crystal Bay,MN 55323 Ap�oved By: Amount S:
Phone(952)249-4600 Faac(952)249-4616
y`��q ti��� CITY OF ORONO—MECHANICAL PERMIT
xEs H�� All Commercial ermits must be a roved b the Buildin Official or Ins
( p pp y g pector and/or Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will
be reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by retuin mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMTT. WORK MUST NOT BEGIN UNTIL THE
PERNIIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Designs—Complete calculations,details and specifications are required for each
heating,ventilation,humidificarion-dehumidification,and air conditioning installation 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 construction or remodeling is involved,a separate building pernut 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.
TYPE OF PERMIT
Check All That A 1
❑Residential ❑Commercial(Approval Required) [Backflow Device: 0 AVB ❑PVB]
❑New ❑Additional ❑Repairs �Replace
Job Site/Owner Information:
Site Address: � d V�IO
Owner�r 1Pn'(11te`C ���CY�SOY� Mailing Address: �1�0 S�Y:1d vVO� �
city: �Y�'�o zip: 5�3� 1
Home Phone: �7� ZU�� ���,� Alternate Phone:
Contractor Information:
Contractor: �- �( DY1( ontact Person: �j(' ��
,,i" �
Address: ���� �CtX 11�� � State Bond#: � �gZ�
City: Zip:�� Expiration Date: �'1 ' Z�"' 0
Phone: �L-835��� Alternate Phone: ��'�W��3�
❑ Insurance—Current:
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Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS TffiS GEOTHERMAL? ❑Yes [�No
HEATING SYSTEMS
Qaantih': I _
Make: �"I
Model: � ��Q��
Fuel: �
Flue Size:
Input BTUs: �
Output BT'[Ts:
CFM:
COOLING SYSTEMS
Quantity. �
Make: �
Model:
Tons: I U f '
H.Power
� FIREPLACES
❑ Gas FacWry 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) cfin
❑ No. Other Fans: Locations cfin
FUEL STORAGE (Must be approvcd 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:
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1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
��f �� x.0125$ �Z"J
(contract price) (minimum$50.00)
2. STATESURCHARGE
x.0005 $ 5
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � ?j Z. �V
■ * CONTRACT 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 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.
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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: /U�.�� Date: '�l��O
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