HomeMy WebLinkAbout2016-00670-VOIDED F R ITY USE ONLY
� � City of Orono -��
�� � P.O.Box66 DateRecei�� � Permit ��`
� 2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By: Amount$:
Phone(952)249-4600 Fax(952)249-4616 9„
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� �.�' CITY OF ORONO—MECHANICAL PERMIT
lqkFS H�� (All Commercial permits must be approved by the Building Official or Inspector and/or F' arsh
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City f pplication 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. ITS NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT IL THE
PERMIT CARD IS POSTED ON THE JOB SITE
3. Mechanical Desi ns—Complete calculations,detaiis and sp a ' ns uired for each
heating, ventilation, humidification-dehumidification,and itioni mstallation including
heat loss/heat gain calculation, design temperatures,eq at' s an identification as to RECEIV�D
type,manufacturer and model. Data shall be presente p 'ded.
4. When any new construction or remodeling is invo � ar i ding permit must be
obtained. ,��N '� � ����'
5. All wark must be done in accordance with the Uni echani Code/State Building Code
requirements. (',;ITI(QF�RONO
6. All work must be inspected(rough-in and final). 11(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitte efore final.
TYPE F PERMIT
(Chec All That A ly)
❑Residential �ommercial(A roval Required) [Backflow Device: ❑ AVB ❑PVB]
❑New ❑Additional ❑ Repairs ❑Replace
Job Site/Owner Informatio
Site Address: ��
Owner: r � Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor In rmation:
Contractor: !'��� ���i �����Contact Person: � l',IL j t �o;��_�.�
Address: �10(j E���S��;� ���� State Bond#: �Qj �1G3 `� �c1
) � 7 v
City: lLt�✓�-� Zip:.55.3`�-�xpiration Date: � —
Phone: [ S� — /a� -��j,3� Alternate Phone: � I� — ��i Z ��/sl�,�
❑ Insurance—Current:
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MECHANICAL SYSTEMS BEING INSTALLED
, �
��� Note: All Geothermal Systems will now require a Site Plan & Review by our Building Official.
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IS THIS GEOTHERMAL? ❑ Yes ❑No
H�ATING SYSTEMS
"Quafitity:
Make:
, �
Model: �
Fuel: ti+R �
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,. • �
Flue Size: � ..� ,
Input BTUs: � - ���
Output BTUs: � . " 'a
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 E�aust(must have ducao tside) recirculating ��
❑ No. Other Fans: Locations cfm
cfm
FUEL STORAGE (Must be approved by Ffre Marshall if proposing to abandon tank in place.) I
❑ Installation ❑ Removal
FuelOil: gallons
LP Gas: ❑ Underground ❑Inside ❑Outside
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$50.00)
��r�� � x.0125$
(con act price) (minimum$50.00)
2. STATE SURCHARGE
x.0005 $
(conVact 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.
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.
ApplicanYs Signature: L� Date: cO ���'���
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