HomeMy WebLinkAbout2015-01314 - mechanical � CITY OF ORONO * 2 0 1 5 - 0 1 3 1 4 *
2750 KELLEY PARKWAY DATE ISSUED: 10/12/2015
� ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 1990 SHADYWOOD RD
PIN : 17-117-23-24-0027
LEGAL DESC : SHADY-WOOD
: LOT 040 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 15,000.00
NOTE: ADDITIONAL: 1 �IEATING SYSTEM(RUUD), 1 COOLING SYSTEM(RUUD)AND 1 KITCHEN EXHAUST&3 BATH EXHAUSTS,
1 GAS LINE TO FURNACE
APPLICANT MECHANICAL 187.50
STATE SURCHARGE MECH(VALUATION) 7.50
SAM HENDRICKSON PLBG&HEATING INC MpIL-IN FEE 2.00
29901 725TH AVE TOTAL 197.00
DASSEL,MN 55325-
Minnesota State License#:plbg-PC646230,mech-MB005006 Payment(s)
CREDIT CARD 7507 197.00
OWNER
VONFELDT&ELAINE WYATT,JEFF
1990 SHADYWOOD RD
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this pertnit is issued shall be perfonned according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. 'fhis 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 consWction authorized is not
commenced within 1 SO 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 Building Code.This permit may be
revoked at any time for due cause. ^
� ��-`�SO � Z
� 1 ��-� �� �j � � I ,
Applicant Permitee Signature Date Issued By Signature Date
.
� FO CITI'115E(3NL1', ���
��� City of Orono . p �
/� P.O.Box GG AaGo RCCCEVC�I:.;.��PerntiB#�:
t./ 27�0 KCIIGy Parkway ':' '
CrystalBuy,MN553Z3 :4ggi0YttlAy;. . :4mQtUt�$;:: �
Phonc(952)?49-4600 fax(952)249-4616 � �
y� �
19� s�to��'G CITY OF ORONO–MECHANYCAL PERMIT
(All CommerCial pemlits must bc approvnd by the Building OffiCial or Inspector and/or Firc MBrshelQ
•
,..
C3��ERL�I..IN�'QR�,�1;'�QN ' , ' ,
1_ You may apply for mechanical pecmits by mail or in person at the City offices. App��cations wil!
be revie�rved and a permit will be issued within two working days_
2. Permit cards will be sent by retum mail after a review is completed. PERMITS AKE NOT
VALID UNTCL'1'OC!RECEIVE A PERMiT. WORK �JST NOT BEGIN UNTIN�T_1�E
PERMIT CARb 1S POST�ri ON THE JOB SETE.
3. Mechanical Desipns—Complete calcul&tions,details and specifications are required for each
heating,ventilsti0n,humidification-dehumidification,ar►d air condiCioning installatipn including
heat loss/heat gain calculacion,design temperpttures,equipment ratings and idet1tification 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
obcained_
5. All work must be done in accordance with the Uniform Mechanica!Code/State.Building Code
requirements.
6. All work must be inspected(wough-in and fin&1). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating TesC Record must be subrnitted before final.
.. .. .... ... .
. : °r�►��°o���,�<�.vtr�
. .
c�ec�A�at'�at. � ~
�Residential ❑Commercial(Approval Required)
❑New �Additional ❑Repsirs ❑Replace
:�flb Sit�!Qwxi+�r�n�or.iria#ions
9 a �o�
Site Address: /� /
Qwner: a�1� � Mailing Address: ��/��!��yG�����"""
City: Zip: ����
H.ome Phone: Alternate phone:
CQn�,racto�.Ciafs��n�tioTt" ` - �
_. . .._,. _ .. . ��:.
`.:.
;... , , .
Contractor:���r�/��r /G�-r►-4K�e�-.��11 Contact Ferson: �.J��i7 ,1�,G9i�SDl�
Address:��9�� ����1'l�`'r SCate Bond#' ���v��d�4
City_ ��i'��J-�� Zip��.�Expiration Date: �� ��
1'hone• � ���/��� Alternate phone: 4.%�' ��� ��-��—�
,� Insurance–Current:
1
g,t:a6pd 9I9b6bZZS6Z��l ZbzSSZzaz� H'8d uos��t,�puaH wpg:wo�� ZS�zS ST02-80-1�0
�
,.,.,... . .,._.. .. „�,...,_,.......:,.. _ _ —- - - �/�y - ' �ir
.._.__ _ -�r.. .w.... .._.. ,.,
�C .aT!'.��dj_�a�iipe�!y,�,/':�J:.� .j; � �`[� � '�4:"i 'iM,«�-,'.�,'',�°!j �'�':+i:h•;;+:ot�:_
,•'�-1���JC;;�'n:2�:11:{:�::Y.\'2�w..::"r .:M' Y�+`-� �'1����y-.�i��»'•i:'!il�ti�vt;�i:';�`.,"ti.;r�
Note:All Geothermal S�stems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTH�1tMAL" ❑'Yes �No
HEATING SYSTEMS
Quantity: r
Make� ��
Model� �� �o�a13>�'��
�uel; �✓ C�
�'lue Size:
Cnput BTUs:
Output BTUs:
C�M:
COOLING SYS'f�MS
Quantity: �
Make; ��u
Model: ���/"�✓/� `
Tons: �
H.Power
FIREPLAC�S
❑ Gss Factory Fireplace Brand Name:
❑ Wood$urning Pireplace
❑ Wood Stove Model No.;
❑ Wood Stove with�lue/Masonry
VENTILATION
� No. � K'rtchen ExhausC duct recirculating cfm
Q No. � Bath�xhaust(must have duct outside) cfm
❑ No. Oi}teC FanS� Locations ' ��
�UEL STORAGE (Must be approved by Frre Marsball ijproposirrg to abandors taak in p1aCe.)
❑ Installation ❑ Removal
�uel Oil: g311ons ❑ �lnderground []Tnside ❑Ou[side
I�F Gas: gallons
Other:
C S LINE ONLY
❑ Outdoor Grill ❑ Other/List What&'Where:
2
g�Z:a6pd 9T9b6bZ2S6Z��l ZbZZSLZOZ� H'8d uos�ot,�puaH tueg:wo.a� ZS�Z� SZOZ-80-1�0
A�:>,,.,� �-.-:;.,;,,:-:,�...,.... r: __
,_��.. .<.�-.,..:. .._ �.,, _ ..........,�.: _ -
'�I �...c.,.r_c�,�::'::r.-�:�'!e•';:+:15.ei:�ril2�'•n�'�' .. . ... ..:... .. .. � ..i:E:','e_.�:,q:r'ri�lni.;_:e��..�,'.'�i.:-_ ....�.�
.,�...�.��.::-::' �, �_:«..�:�.;,�.,_.�.v..+�.=-w``.�' '�'�i ��� 'i'�• } :.��%-^!i�•!
M �.,l.� �,f::,�b-,M�i.._I.Y.C-:,:?'.
,::r' -- -- ctt.t,.,�;:,w�r•.::D�. v.- _,� -�i i� _ ��_,.,,::. K��..N",,^n,'_,;f":;j;
,.�y:,��,:�:�:�::���._.. r.r .:_ ..:� � .._� "._�"'.t� ;.��;�;,:,=:�:�,:;<�:�_
, v�
�.�,.._.:�_W::s ...��_.... .��n,i�'' .�"�'_ _ tir..!.�• -=.;1� ,:.N.Ji: �M1�'S�r.: , '�I..:.
%���Jr.,�;:.�.,..�.................. .��.�':.�"T'..��:r.� �y� .-..:�" .;... j;�}::. i.S�'. 7 _ _ '=��J'`�:
Y.,i:F'_:,._n.:_ ..a��';�n,; ,y�-�3`�i_v_# +„� ��t'�, ,'��;:� � ",t .`r;k„c;;�;i F:�iV!ri^iir'i:e�f�•:«_�,r;"•~�4.��;:':vjj:_.
:,,..w =-�;.�:, p r .d`y �„:w:= '�j��. p +. yt �`F � �: .-.'r;:•:�;1:J. +t i-,a,,..,..��..,.,,.cc �..c......
:-:.. ���::f.`84�!�,� ���G', ���� �:�a�z ;�
�n1���.,� r�....::^..y`. '...._.._....... . A .t•ii�,:�kr_R.ria�:t: C- .... .
...�._,.. •�" ...r'=Jt•1�Xi`xt �'� . t����..�.1�..�.�=!''. �������!•_._a[:+. +`�W��.:._._ ,Ir.�%E^,,�„�ir�:;;�Gi;41:y
� � ,..�- (C��..
Q �S''es,this sectiqn applies
The rep{acement of a Etesidential fixture or annlianG�that meets all three of the following requirements;
1. Does not require modificatian ta electrical or gas serviCe.
2. Has a total cost of$500.00 or less;excludin8 the cost of#he fixture or applianct:and
3• Is improved,installed or replaeed by the homeowner or licensed conttaetor.
Skip next section,if this applies; Cost of Pennit $ 15.00
State Surcharge $ 1.00
Mail-In Fee(If Applicable) � 2.00
Total Permit Fee $
;.��:..�:-,. ,•:--:.--•,.... �;_y:� - - _ ��;��-
_. .,;� ........ .: . . ..,,., ; ;�:-.:,;., .,,., ,
---=-.`,,�::3-: __r�=f:t• _ - �i`'i .;;" %;r�:::�;:;-C�:ia,:a<�::_;::�iss'=;��
._... ;,. .
._Y�.�I...,_,a„-.,,,,,,..�ez.,�d!:S.:Tr•• ,, t .- - ";�; �;`+?:jic`-- _
,
. :: ..:,, ,
_. :.,
„. . , ,. �• -.
,
.
...
, .. _ .-
,. ..
-::-,�r:�:,.,:,;a.......:..:................�.._ . - u . ._.._...,:.... . . ...,..,..,. , .,., ._. . .:...,.`....':a. .,.s::� .
If above does noT apply;follow guidelines below:
l. COIYTRACT PR[CE " is 1.25%of contract price with s(Minimum�ee of$50.00)
/�"�,r� X.a�zs� l�7�5"�—
(contrect pnee) (minimum$50.00)
2. STATE_ URCHARGE
�c,���•� x.0005 $ ��
(canvac[price)
3. POSTACyE&HANDLING(OnI�on Mail-Cn Applications) $ 2.00
4. TOTAL PERMiT FEE(Add�,ines I-3 Above) $ �,O�+'`�
■ " CONTKAC7' pRICE or JOB COST rneans the actual or estimated doltar amount charged far the
permitted work includin�materials,labow,profic,and other fixed eosts. It is the amount to be char�ed
to the customer for the work done. Cf an�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
estimaced cost or eontraet price for permit fee purposes. In the evenC that there is a dispute on the
amount of the job cost, the City may requesC the subroission af a signed copy of the actual contract.
,.....�:,:::...,.:_�..;........:�.,.,,.,._ , :.,_ ,;. ,.. . - -_-- - - - _ - -
,..:��.............._.e:_!,�''�,.�.:,..:.:_•. .1 ... � �.. I� :Ir�� .� T j N'�� •:�2�i���.i�:���y`.i:�;.�!'.�.�:��:;�,!':�'
:::V!,r"..y. .. „�..N��'='Y1•�:••�� {� � - l . ��-Sf.J
� - :,, ,= ...
...,.:1:',etc..._F:t.'i,ilc','F�'"3':'....�" • . ii�,'� 4. _' 9,'.Y' '
� . y.
� � : . ,
.�
�
. ' "
, ..
,'
• .� h•
�. .,.,,,,.i.�, ..,,,., � . � „ . .. . . . �. , ....._._._. °
. . . ._
�:r, .,.. ..:.0...,.;.,.
The undersigned hereb� 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 certifres that all statements rnade on this application are complete, true and
correct.
, �' /� � ,t�
Applicant s Signature• ����
3
g,£:a6pd 9I9b6b22S6i��l ZbZZSZZ02� H'8d uos�ot,�puaH weg:wo,�� zS�Zi SZ02-80-1�0
� � \�
� ��`� ME V
CITY OF ORONO CALLED IN �I D�.'L�S TI
INSPECTION TICE��3! SCHEDULED //-/�-/S �DZ�__
PERMIT NO ,PLETED
ADDRESS � ����I� ��
OWNER LEP `� N .���a �
CONTRACTOR
� DESCRIPTION � �
�
W ❑ FOOTING ❑ DEMO-FINAL SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB [�IECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
Z
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 �NNERICONTRACTOR TO MEET YiOU:_YES_NO
y COMMENTS:
W
� SGD�I�os _ ✓'C��t✓vt..f —
�
J
O �^ ' .
� �'1"/�� /K,S'�4�1�..5����a.S�,i r�is/�Lf
O � _
�... G.G.
W
�
Q
2 �t5� ' ��
W
�
W
�
J
d
W� ❑WORK SATISFACTORY:PROCEED ❑PRW ECT COMPLETE
W�L'd�88ECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
O O CORRECTYYORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REW IRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OMmerlContraator on site: �� '�
Inspector: � fw-�-
White Copyllnspector's Ffle Canary CopylSits Notiee
� �
� DATE TIME
CITY OF ORONO cnLLED IN �
INSPECTION NOTICE �EDULED
PERMIT NO. ��D� C MPLETED
ADDRESS
OWNER TELEPHONE �a � �
,
CONTRACTOR
� DESCRIPTION
�`r � .
4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALI ❑ PLUMBING RI ❑ EXCAV/GRADING/FILL�NG
"3 ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
_ ❑ FRAMING �CHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ EPTIC INSTALL
Z OWNERlCONTRACTOR TO MEET 1IpU: YES_NO � �„
y COMMENTS: � �l� ' ���t3 0�
� `///�3tt�.Pi r/rv�.,jC �� 1/e� .
�
o _hQ/�r�c� �/l v
� ��6t! �t�t �•x�e•�:�- lia�a.Qs
o , •
W �—,�2t�c�f•�L� c�s /r�r a.
�
Q
�
a
� rv�l�e-u�a•�' � �iC
�
�
0
W ❑WORKSATISFACTORY:PROCEED ❑ PRWECTCOMPLEfE
� ❑CORRECT W'ORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑(�RRECT WORK�LL FOR REINSPECTION TEMPORARY
V BEFORE COA/ERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
1�4NSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
��
Catl for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlCorrtractor on site• 6t��
Inspector: �i�^- .
WhiM CopyAnspecto�'s Ffle Cenary CopylSite Notfce
c � -� ��
<�� DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED � Z
PERMIT NO. :/� '/ COMPLETED
ADDRESS C ; `�' Cc� c%C� ;�
OWNER TELEPHONE N .
CONTRACTOR �
� �
� DESCRIPTION � � / �
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL , 1
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLI G
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
�4 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ TIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU: YES_NO
v�, COMMENTS:
a �
�
J
O
).
�
O
�
W
�
Q
�
2
W
�
W
�
�
W ❑WORKSATISFACTORY:PROCEED PROJECT COMPLEfE
� ❑CORRECT VYORK 3 PROCEED ❑ SSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WFLL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 urs in adv� ) 249-4600
OwnerlContractor on site:
Inspector. �/ � '
� t
White Copyllnspector's File Canary CopylSite Notice