HomeMy WebLinkAbout2017-00144 - duct work CITY OF ORONO * Z 0 1 7 - 0 0 1 4 4 *
. 2750 KELLEY PARKWAY DATE ISSUED: 02/22/2017
*
�. ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2500 SHADYWOOD RD
PIIV : 20-117-23-11-0034
LEGAL DESC : REG. LAND SURVEY NO. 1630
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : COMMERCIAL- BUSINESS
CONSTRUCTION TYPE : DUCT WORK
VALUATION : $ 12,000.00
NOTE: DUCT WORK FOR JOHN HENRY SUITE
APPLICAI�TT MECHANICAL 150.00
STATE SURCHARGE MECH(VALUATION) 6.00
AIR QUALITY SERVICES [N. TOTAL 156.00
7900 EXCELSIOR BLVD
SUITE#750 Payment(s)
HOPKINS,MN 55343- CREDIT CARD 7316 156.00
(952)401-3838
Minnesota State License#: mech-MB003119
OWNER
Ugorets 8098 LLC
410 1 1TH AVE S
HOPKINS, MN 55343-
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 1 SO 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. - �
�(�J.�.
/�
�—
_,�� � ,
/• ;, . � < '' � � �
��-��' �� /7 ��Q�t _.�;_ �fi ��� c,, � �
� - � � �
Applicant Permitee Signature Date Issued By Signature Date
�� FOR CTI'Y USE ONLY
�O� City of Orono /I 17�� /�
M P.O.Box 66 �) Date Received: �- � � ermit# G V� �J(- ' f �`�
0 2750 Kelley Parkway � o
f Crystal Bay,MN 55323 � Approved B . ount$:�
Phone(952)249-4600 FaY(952)249-4616
y ;
�lqkESH���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 UNT1L 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 wark 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 fmal.
TYPE OF PERMIT
(Check All That A ly)
❑ Residential �Commercial(Approval Required) [Backflow Device: ❑AVB ❑ PVB]
❑ New ❑Additional ❑ Repairs ❑ Replace
Job Site/Owner Information:
Site Address: ��� ����,f �,J-},r �ei'
Owner: � ���'S Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
� �\
Contractor: 1( � ��'�'u� Contact Person: �r✓��c.. V v,`�,,,,�-r�
Address: �GYj �X� lS��,r,�jd�State Bond #:
City: `� Zip:.�S�3 Expiration Date:
Phone: ���'- - ��j''��.�d� Alternate Phone: � �Z -Z�Z-����'
�
❑ Insurance-Current: �
�
1 �
w
�
��
Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. `
IS THIS GEOTHERMAL? �yes ❑No
HEATING SYSTEMS
Quantity: p � r 1 � ^
l�v� �(�
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
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 Exhaust
❑ No. Bath Exhaust(must have ductoutside) recirculating ��
❑ No. Other Fans: Locations °�
cfm
FUELSTORAGE �
(Must be approved by Fire Marshall if proposing to abandon tank in plac�)
❑ Installation ❑ Removal
FuelOil: gallons
LP Gas: ❑ Underground ❑Inside ❑Outside
gallons
Other:
GAS LINE ONLY
❑ Outdoor Gril] ❑ Other/List What&Where:
2
�
� ..... .+- .. . .. ..,. - - ..- , , .
1. CONTRACT PRICE * is 1.25�0 of contract price with a(Minimum Fee of$50.00)
x.0125$
i (contract price) (mioimum$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 m�terial,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 fe�purposes. In the event that there is a dispute on the amount
of the job cost, the City may request tlie submission of a signed copy of the actual contract.
The undersigned hereby applies to the City P'or issuance of a Mechanical Permit, agrees to do all
work in strict accordance with the ordinan�es 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: �� G�.-�j��� Date: Z �-��7
� -
I�
�
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N TICE SCHEDULED
PERMIT NO. �� COMPLETED �
ADDRESS 0 '
OWNER TELEPHON NO.
CONTRACTOR
� DESCRIPTION �
4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
"3 ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI I ❑ SITE INSPECTION
Q ❑ FRAMING MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ' ❑ COMPLAINT
� ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERK:ONTRACTOR TO MEET Y�OU:_YES_NO
y COMMENTS:
a�
�
o � l �t .Q
'' c 6� � C9
�
0
W
�
Q --- — —
�
2 � - -
�
W
�
�
W O WORKSATISFACTORY`.PROCEED OJ�CT COMPLEfE
� ❑CORRECT W'ORK 8 PROCEED �ISSUE�ERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CONERIN(i __T pERMANENT
❑CORRECT UNSAFE CONDITION WRHIN HOURS. p pHpT�:,TAKEN
INSPECTOR WFLL RETURN
�STOP ORDER POSTED.CALL INSPECTOR O CITATIaN ISSUED
❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS.
cau�or the next inspect�on 2a hours in advar� (952) 249-4600
on site:
.
inspector:
yyMM Copypnapector's Fils Cenary C¢pylSke Notiee
C � � � ���'
DATE TIME
CITY OF ORONO �f��CALLED IN =e==�
INSPECTION NOTICE SCHEDULED � -� 7�/frr�
PERMIT NO.{—��- l COMPLETED -�
ADDRESS �� ��C� - S {�C e c,/ �/ ��-��� l�
OWNER TELEPHONE NO. ���'� ���/ ���
CONTRACTOR - •� �L�
� DESCRIPTION (�c_ C-�- (��t>12 IC.._. /G�� (
tL ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ 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
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ S IC INSTALL
2 OWNERICONTRACTOR TO MEET YiOU: YES_NO
y COMMENTS: �� � �n
�
�
o � � ���'il�—
�.
�
° ��i� v� - p �
W
Q � �Y�
�
2
W
�
W
�
J
W WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
❑ RECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContra n site:
,
Inspector: �, `�
White Copyllnspector's Ffle Canary CopylSfte Notice