HomeMy WebLinkAbout2016-00405 - fuel storage tank removal CIT� OF ORONO * 2 0 1 6 - 0 0 4 0 5 *
' 2750 KE�.LEY PARKWAY DATE ISSUED: 04/27/2016
,� ORO�TO,MN 55356-
(952)249-460 FAX: (952)249-4616
ADDRESS : 2500 SHADYWOOD RD
PIN : 20-117-23-11-0034
LEGAL DESC : REG.LAND SURVEY N0. 1630
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : COMMERCIAL-BUSINE3S
CONSTRUCTION TYPE : FUEL STORAGE TANK RFMOVAL
VALUATION : $ 5,033.38
NOTE: INSPECTIONS ARE DONE BY FIRE MARSHALL,JAME$VAN EYLL.
PLEASE CALL JAMES VAN EYLL DIRECTLY AT:(952)473-9701 TO SET UP AN INSPECTION.
APPLICANT MECHANICAL 62.92
STATE SURCHARGE MECH(VALUATION) 2.52
PUMP&METER SERVICES MAIL-IN FEE 2.00
11303 EXCELSIOR BLVD. TOTAL 67.44
HOPKINS,MN 55343
(952)933-4800 Payment(s)
CHECK 32455 67.44
OWNER �
Ugorets 8098 LLC
410 11TH AVE S
HOPKINS,MN 55343-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to II
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires sepazate I
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.l'his permit will �
expire and become null and void if construction authorized is not I
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be �
revoked at any time for due cause. F
►. ` ' �,.,e�e'`�� i �1i
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Applicant Permitee Signature ate Issued By Signature Date
FOR CITY USE ONLY
� City of Orono .� /� �
� ���� P.O.Box 66 Date Received: �f / � Permit# �G/� V'����
2750 Kelley Parkway �/�
' ' Crystal Bay,MN 55323 Approved By: �v Amount$: r � „j
Phone(952)249-4600 Fax(952)249-4616
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C�-�n Ar���-�-
`�KfSH���G 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 Designs—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 final). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitted befare final.
TYPE OF PERMIT
(Check All That A 1
❑ Residential �mmercial(Approval Required) [Backflow Device: ❑ AVB ❑ PVB]
❑ New ❑ Additional ❑ Repairs ❑ Replace
Job Site/ Owner Information:
Slte f�dC�T'eSS: � `Y5�[.•uJ`�v / da.uJo�•on �2 5�00.��j4�y v�+ �`c� ��<r. �!ir�i�7�� � ` 1
Owner: G!9 0� _�.s �d 9'? t l (° Mailing Address: G�/O �J��/��• .�
City: �o/���'. _r Zip: �s3`/�
Home Phone: Alternate Phone: `0���- "%�`�:' 7 2 ��g
Contractor Information:
Contractor: (�u w� -/�r��. frr v+c-� Contact Person: /3��� �r>�
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Address: ))�oJ /_—��r/1,'o,�/�l�G/ State Bond #: /'��P��`(407
City: �o,o�i:�, � Zip:SS��i3 Expiration Date:
Phone: ��� �91?- yf�� Alternate Phone:
❑ Insurance—Current:
1
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Note: All Geothermal 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:
Output BTCTs:
CFM:
COOLING 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
VENTILATION
❑ No. Kitchen E�►aust duct recirculating cfin
❑ No. Bath Eachaust(must have duct outside) cfin
❑ No. Other Fans: Locations cfin
FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.)
❑ Installation � Removal
Fuel Oil: `7;Oc+o 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 1.2�°/a of contract price with a(Minimum Fee of$50.00)
so�33. 3$ X.0�25 $ � a. 9a
(contract price) (minimum$50.00)
2. STATE SURCHARGE
Sb v�3. a 8 x.0005 $ 0�1 .J�
(contract price)
3. POSTAGE&HANDLING(Only�on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ (e'1.y�
■ * 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 nlaterial,equipment,labor or installations are furnished by the
owner, tenant or any other party, the re onable market value of such items must be added to the
estimated cost or contract price for permit f e purposes. In the event that there is a dispute on the amount
of the job cost, the City may request e 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.
Applicant's Signature: C�_`�, Date: `y����L
� 3
DATE TIME
CITY OF ORONO CALLED IN �� q �D
INSPECTION NOTICE SCHEDULED `�L���
PERMIT NO.,,��� " (�v�� COMPLEfED
ADDRESS a
OWNER TELEPHO NO.��' 3 3— �7
CONTRACTOR r�.�+^ �- �. �
� DESCRIPTION G� � ���''�'''�'�
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ 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
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OYIlNERfCONTiUCTOR TO MEEf YOU:�YES_NO
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W ❑WORKSATISFACTORY:PROCEED j$�ROJECT COMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 forthe next ins ion 24 hours in advance. (952) 249-4600
OwnerlContractor on site: �O�
Inspector. �� �'+^-� � �� e, ��
White Copyflnspector's Ffle Canary CopylSite Notice