HomeMy WebLinkAbout2017-00974 - mechanical . �
CITY OF ORONO * 2 0 1 7 - 0 0 9 7 4 *
2750 KELLEY PARKWAY DATE ISSUED: 08/16/2017
ORONO, MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 2455 SHADYWOOD RD
PIIY : 20-117-23-11-0017
LEGAL DESC : TOWNSITE OF LANGDON PARK
: LOT 002 BLOCK 004
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTIOI�T TYPE : COOLING SYSTEMS
VALUATION : $ 5,352.00
NOTE: (1)LENNOX 5 TON A/C
APPLICANT MECHANICAL 66.89
STATE SURCHARGE MECH(VALUATION) 2.68
SEDGWICK HEATING&A/C MAIL-IN FEE 2.00
1408 NORTHLAND DR-SUITE 310
MENDOTA HEIGHTS,MN 55120- TOTAL 71.57
(952)881-9000 Payment(s)
CHECK 17810 71.57
OWNER
ENGLUND, PAUL&JEANNE
P.O. BOX 95
NAVARRE,MN 55392-
AGREEMENT AND SWORN STATEMEIYT
The work for which this permit is issued shall be performed according to
[he 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 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 authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time afrer 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. `
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Applicant Permitee Signature Date Issued By ignature Date
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City of Orono �/�, � � 7 �'
�O� P.O.Box 66 p� y Date Receive �f' � Permit# �
� 2750 Kclley Parkway �Uo � lf�U 1� �
Crystal Bay,MN 55323 Approved By: Ainount$:��
� � Phone(952)249-460QI�(�5���4�NO
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`� �.�' CITY OF ORONO-MECHANICAL PERMIT
���SN j (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL INFORMATION
l. You may apply for mechanical permits by mail ar 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 1S POSTED ON THE JOB SITE.
3. Mechanical DesiQns—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air conditioning installation including
he�t loss/heat gain calculation,design temperatures,equipment ratings and:�!er.tificati3n zs 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 wark 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
�f Residential ❑Commercial(Approval Required) [Backflow Device: ❑AVB ❑PVB]
i�
❑ New ❑Additional ❑Repairs ❑Replace
Job Site/Owner Information:
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Site Address: ,��SS ���.�li.G�1�V�{ (,�'� K-Z�--�
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Owner: �V��,L,���� , �'l_,�?--� Mailing Address: �� L`:>j , ��%�,� ��`�"�ti�- �-�� _
City: .,��I�Q�Gy- L?������'l�'1� Zip: ,����.� I
Home Phone: Alternate Phone:
Contractor Information:
Contractor: , `° ' ° (,' .�, �4�-�� Contact Person: �1�� �'�'���.
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Address: ���� I�G1�'�Vt,t.17,J�t,tJ�- �'� State Bond#: ��l,h f���-'-��U3
City: ��,'�,�, l, .'�� 1�p:J��ZU Expiration Date:
Phone: �Sr3���' �'���`��� Alternate Phone:
❑ Insurance-Current:
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Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes �No
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HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity: �
Make:
Model: ��1�
Tons: J
H.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) cfrn
❑ 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:
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1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
S35a.(� X.oi2s$ (.�V .�a
(contract price) (minimum 550.00)
2. STATE SURCHARGE t3 s� � X.000s $ �-Lt �
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ! l �S{l
■ * 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 fumished 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.
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The undersigned hereby applies to the City for issuance of a Mechanical Pernut, 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: ti U�.� Date: �j� ��` ��
3
DATE TIME �
CITY OF ORONO CALLED IN �
M18PECT10N NOTICE SCHEDULED �
�Mrr No. �o►ti -o0 9'7y coM���
a�Ess ayss S.f��,��
OMINER TELEPHONE NO.
CONTRACTOR
� DESCRIPTION
11� ❑ FOOTINCa ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
� ❑ FRAMING �Gi'sHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑COMPLAINT
� ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
�Y ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
Z 01NNB�ITRACTOR TO YEET V�01J:_Y68_NO
� COMMENT�
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� O W�OFiK SATISFACTORY:PFiOCEED �PR�.CAMPLETE
W O WRRECT WORK 3 PROCEED ❑ISSUE CERTIFlCATE OF OCCUWINCY
O� ❑OORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CaVERINO PERMANENT
❑CORRECT UNSAFE OONDITION WITHIN HOUR3. p p�.�pTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDEH POSTED.CALL INSPECTOR ❑pTATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRAN(iE ACCESS.
caN ta n�e next inspectlon 2a na,rs h eananoe. (952) 249-4600
on site:
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