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Home My WebLink About2016-00498 - mechanical T � CITY OF ORONO * Z 0 1 6 - 0 0 4 9 8 * 2750 KELLEY PARKWAY DATE ISSUED: 05/09/2016 ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 2171 SHADYWOOD RD PIN : 17-117-23-42-0022 LEGAL DESC : BRENTEN WOODS : LOT 002 BLOCK 001 PERMIT TYPE : MECHANICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : COOLING SYSTEMS VALUATION : $ 6,100.00 � NOTE: (1)MITSUBISHI COOLING SYSTEM MODEL#MXZ2B20NA 1 - 1/2 TONS APPLICANT MECHANICAL 76.25 STATE SURCHARGE MECH(VALUATION) 3.05 CENTERPOINT ENERGY MAIL-IN FEE 2.00 6161 GOLDEN VALLEY RD BUILDING A TOTAL 81.30 GOLDEN VALLEY,MN 55422- Payment(s) (763)512-2765 CHECK 20255 8130 Minnesota State License#:mech-MB003503 OWNER ROBERTSON,JACQUELYN 2171 SHADYWOOD RD . WAYZATA,MN 55391- 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 tt►e work described and dces not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction suthorized is not commenced within 180 days of the date of issuance,or if construcrion 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. / . � d� S � � � �( Applicant Permitee Signature Date Issue y Signature Date L � RECEIV�D , t 1�,�A / O City of Orono �IN I � � D R O% TY U Pe�O1NLY �� ./ � N� Z��6 �� '�D/� �a� P.O.Box 66 ate ece ��'� 2750 Kelley Parkw y� Crystal Bay,MN��N�F QRQN� Approved By: Amount$: (J�� Phone(952)249-4600 Fa�c(952)249-4616 y � � 1 `�kBSH��G CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official or Inspecror and/or Fire Mazshall) 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. PERNIITS ARE NOT VALID UNTIL YOU RECEIVE A PERNIIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desi�ns—Complete calculations,details and specifications are required for each heating,ventilation,humidiftcation-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 before final. TYPE OF PERMIT Check All That A 1 �Residential ❑Commercial(Approval Required) [Backflow Device:❑ AVB ❑PVB] ❑New ❑Additional ❑Repairs ❑Replace Job Site/Owner Information: Site Address: 2171 SHADYWOOD ROAD Owner: JACKIE ROBERTSON Mailing Address: 2171 SHADYWOOD RD City: ORONO Zip; MN Home Phone: 952-471-9059 Alternate Phone: Contractor Information: Contractor: CENTERPOINT ENERGY Contact Person: JOANN ZINKEN AC�C�T'eSS: 6161 GOLDEN VALLEY RD,BLDG A St3te BO11C1#: MB003503 Ci�: GOLDEN VALLEY Zlp: MN Expiration Date: osi2oi2o�s Phone: �s3-5�2-2�s5 Alternate Phone: OLD REPUBLIC INSURANCE C0. ❑ WORKERS COMP&EMPLOYERS LIABILITY II1SUraI1Ce—CUI�T�e11t: POLICY#WLRCC48597075 oni irv oGainn_n�m�nn�as+�mnp�� 1 � . � � � Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. IS THIS GEOTHERMAL? ❑ Yes Q No HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: Input BTUs: Output BTUs: CFM: COOLING SYSTEMS Quantity: � Make: MITSUBISHI Model: MXZ2B20NA Tons: 1 1/2 I-�.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 cfm ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfin FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List What&Where: 2 � . � J � t, . � .. .:4 r. ....: ....: .� 4,- � , . � � � � s, �. : .. . �: � :, . : " . �. 'd., :, f� . .<.� , , : . ,. ��.t.., .�. ..,�.,,�.,w.. - N ' ��' �.,� 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) 6100.00 x.0125 $ 76.25 (contract price) (minimum$50.00) 2. STATE SURCHARGE 3.05 6100.00 x.0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 81.30 ■ * 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. , s v . � - . . �;, . . . . . . �. � E w:�. . ,. �. , . . w , � 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: Date: 04/28/2016 3 V �� DATE TIME CITY OF ORONO CALL— E�iN , INSPECTION NOTI SCHEDULED PERMIT NO. COMPLETED ADDRESS OWNER C � � � � CONTRACTOR � t � DESCRIPTION � 4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATE ROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB �MECHANICAL RI ❑ SITE INSPECTION _ ❑ FRAMING ,� MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION �OOD BURNER/FIREPLACE ❑ COMPLAINT � ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ v ❑ DEMO-SITE ❑ S TIC INSTALL Z ONfNERICONTRACTOR TO MEET 1I�U: Y _NO � COMMENTS: � ��. �'�.� � s- a s^- � � a M.'�,: i�rs c�l �� d4,� - � � 0 � Ic.br K C'b,+�,iQ1�c�.f b,O.�t��5 ��— O � W � Q � � � W � � ,�rv�w.ofi T/�i�I1� J W O WORK SATISFACTORY:PROCEED �OJECT COMPLETE � ❑CORRECT W'ORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W � ❑CARRECTYYORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR YVILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cafl for the next inspection 24 hours in advance. (952) 249-4600 Ow�rlContractor on site: Inspector: WhiM Copyllnspector's Flle Cenary CopylSite NMk:e