HomeMy WebLinkAbout2015-01139 - mechanical CITY OF ORONO * 2 0 1 5 - PJ 1 1 3 9 *
.�► 2750 KELLEY PARKWAY DATE ISSUED: 09/08/2015
ORONO,MN 55356-
4 952 249-4600 FAX: 952 249-4616
ADDRESS : 1810 SHADYWOOD RD
PIN : 17-117-23-21-0027
LEGAL DESC : SHADY-WOOD
: LOT 022 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 11,534.00
NOTE: REPLACE EXISTING HEATING&COOLING SYSTEMS
APPLICANT MECHANICAL 144.18
STATE SURCHARGE MECH(VALUATION) 5.77
PRONTO HEATING&AC MAIL-IN FEE 2.00
7588 WASHINGTON AVE S
EDEN PRAIRIE,MN 55346- TOTAL 151.95
(952)835-7777 Payment(s)
CHECK 10945 151.95
OWNER
RICHARDSON,CHAD&JENNY
1810 SHADYWOOD RD
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this pertnit 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 after work has commenced.
The applicant is responsible for asswing all required inspections are
requested in conformance with the State Building Code.This permit may be n,_
revoked at any time for due cause. ., ��,1�
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Applicant Permitee Signature Date Issued By Signature Date
'� FOR CITY USE ONLY
City of Orono
' �O�O P.O.Box 66 Date Received: �Permit# ��, r f
2750 Kelley Parkway 7
Crystal Bay,MN 55323 Approved By: � Amount$: 15 f
Phone(952)249-4600 Fax(952)249-4616
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`qkfSH���` CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will
be reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desi�—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air conditioning installation including
heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to
type,manufactu:�r und model. Data shall be presented on form provided.
4. When any new construction or remodeling is involved,a separate building permit must be
obtained.
5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code
requirements.
6. All work must be inspected(rough-in and final). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
Check All That A 1 )
�Residential ❑Commercial(Approval Required)
❑ New ❑Additional ❑Repairs �Replace
Job Site/Owner Information:
Site Address: � � � U S��ti wv�� �oo-�{
Owner: 1,V�0.� I��cv��+ra�S�-� MailingAddress: ��1(� Sl.,o�c�-Yw���� ��G�
City: �rati�� Z�p; �s3� 1
Home Phone: `��'Z �y� � �Z��� Alternate Phone:
Contractor Information:
Contractor: �rv►�{v H�fihq �� �t�.Contact Person: �v�t��n�_
Address: �4 �1�5 Wcs�`��i�v��SState Bond #: ML�Ot?�f$Z'�
City: �,t.� Q�i.,�r�t Zip: /�/� Expiration Date: �y/ l�P
Phone: �ISZ ' �i 35��� � �� Alternate Phone:
❑ Insurance—Current: �(e S
1
.� MECHANICAL SYSTEMS BEING INSTALLED
Note: All Geothermal Systems will now require a Site Plan& Review by our Building Official.
IS THIS GEOTHERMAL? ❑ Yes �No
HEATING SYSTEMS
Quantity: I
Make: V Y1 i CeI i"Gv�W1 I
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity: �
Make: �ry a� I
Moae�: �L�O g NR
Tons: �
H. Power
FIREPLACES
❑ 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
FUEL STORAGE (Must be approved by Fire Marshall ijproposing to abandon tank in place.)
❑ ]nstallation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Griil ❑ Other/List What& Where:
2
PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture 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 less;excludine 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 Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
PERMIT FEE CALCULATION S -JOBS OVER$500.00
If above does not apply; follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
►� s 3`f X .oizs $ {yy� /�
(contract price) (minimum$50.00)
2. STATE SURCHARGE
1 I 5 3`I X.000s $ �.] 7
(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 furnished 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.
MECHANICAL PERMIT APPLICATION AGREEMENT
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
wark 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: �� �OL— Date: (�$�3���,j
3
f �.
�� DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC SCHEDULED ���s�
PERMIT NO. � !� COMPLErEO
ADDRESS � � ---��
�NNER TELEPHONE NO.��a 8��77�
CONTRACTOR ; '
� DESCRIPTION � —_�
ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING �,ECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ ER HOOK-UP ❑ FOUNDATION/REMOVAL
Z
r ❑ DEMO-SITE ❑ PTIC INSTALL
2 OMINERlCONiRACTOR TO MEET YOU: YES_NO
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� O WORKSATISFACTORY:PROCEED �41ECT COMPLETE
W ❑C�RRECT WORK�PROCEED ��0 ISSUE CERTIFlCATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C� �F���N� PERMANENT
❑CORRECTUNSAFECONDITIONIMTHIN HWRS. O PHOTOTAKEN
INSPECTOR 1MLL RETURN
❑STOP ORDER POSTED.CAII INSPECTOR ❑pTAT10N ISSUED
❑INSPECTION REQUIRED.CALL TO ARRAN(3E ACCESS.
caY ror tne next inspect�o�2�no�,rs in advanoe. (952) 249-4600
on site:
inspector. �'�' �`--� �
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