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- CITY OF ORONO PERMIT NO.: 2010-00313
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE IssuEn: 05/1 U2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 2477 SHADYWOOD RD
PIN : 20-117-23-11-0027
LEGAL DESC : REG.LAND SURVEY NO. 0088
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 23,000.00
NOTE: (4)HEATING SYSTEMS-RHEEM-MODEL#R6RL-l0E-ZAJS-NATURAL GAS-3"FLUE- 100,000 INPUT BTU'S
97,000 OUTPUT BTU'S-4 TON CFM
(4)COOLING SYSTEMS-RHEEM-MODEL#13AJL48A01-(2)ARE 4-TONS,(1)3-TON,(1)2-TON
COZY HEAT GAS FACTORY FIREPLACE
INSTALLING 300 FEET OF DUCTWORK
APPLICANT MECHANICAL 287.50
TONKA PLUMBING HEATING&COOL INC. STATE SURCHARGE MECH(VALUATION) 11.50
265 CTY RD 110 NORTH
MOLJND,MN 55364 MAIL-IN FEE 2.00
(952)472-9200 TOTAL 301.00
Minnesota State License#:060524PM
OWNER
IMF
, IMF
1109 EAST MORE LAKE DRIVE
FRIDLEY,MN 55432-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perfortned according to
the approved plans and specifications,applicable Ciry 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 consVuction 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.
'� / �/ //O S� // �/O
Applicant Permitee Sign'ature Date Is y Signa ure Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
May 06 10 10;27a TONKA PLUMBING � 952-472-9220 p.2
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��� 1� FORCITY USE ONLY
i''�.. City of OroQo
��� �`�� P.O.Box 66 Date Receive : � /D Permit fil o�/�`���
i�.:._ �" 2750 Kclley Parkway ,O Q
'' �>1.!. ". ��� Crystal Bay,MN 55323 Approved By: ^ G Amounl$:�/` �
'�� ��r��,;�,��o� (952)249-460D
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CITY OF ORONO—MECHANICAL PERNIIT
(All Cornmercial permits must be appro.ved by the Building Official or Inspec�ar and/or Fire Mars6all)
GENERAL 1NFORMATION
1. You may apply for mechanical permits by mail or en 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 retum mail after a review is completed. PERMTtS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT B�GIN UNTIL TH�
PERVIIT CARD IS POSTED ON THE JOS 51TE.
3. Mechanical Desis�ns—Complete calculations,details and specifications are required fnr each
heating,ventilation,humidification-dehumidificatio�t,and air conditioning installation including
haat loss/heat gain calculaiion,design temperatures,equipment ratings and identification as to
type,manufacturer and rnodel. Data shall be presented on form provided.
4. When any new construction or remodeling is involved,a sepazate building permit must be
obtained.
5. All work must be done in accordance with the Uniform Mechanical Code/Sta#e Building Code
requirements.
6. All work must be inspected(rough-in and fuial). Call(952)249-4600.
(24-48 6onr notice required)
7. House Heating Test Record must be submitted before final.
:
TYPE OF PERl1�1IT
Check All That A 1
❑Residential ��Commercial(Approval Required) �
❑ New ❑AdditionaF ❑Repairs �Replace
Job Site/ Owner Information:
s�t� Aaaress: �- � 51�.c�i t�, r��
.�.y�l�ar����'.�-n�l�n i 5 i cc�
Owner: F��1�,,.r�i��'�o Mailing Address: � ��Ji� ��;�jb�
C.ITy. �I Vl{1'�C.�l,��r� 'vl�l V Z,lp. �7�t'7�e '
Home Phone:�b�3- ��I�S�1 �?� , Alternate Phone: �a.X �7 �3-- S �7I" �$3�
�
Contractor Information:
Contractor: "ts'�1C�- I �iv�ontact Person: ��i��"�►'avr.'�J��
J
Address: ?�oe,�_ ,(L_�I,��J� State Bond#: �3�1�I' 1017 S $
City: I�Y�4L�.�tnt�- Zip:, �v�Expiration Date: �1�� �t0 �/�,n�v�
Phone_ �1��.'�-I�—I a—�J1.�L� Alternate Phone: C'�. �1�- �D��(al L�
❑ Insuiance—Current: l�e� •
I
May 06 1,0 10:27a TONKA PLUMBING 952-472-9220 p.3
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MECHANICAL SYSTE]vI�;BEiNG IlVSTALLED
Nate: All Geotherrnal Systems will now require a Site 1 &c�Reviev�+by ow Building Official.
Y5 THIS GEOTHERMAL? ❑.Yes �.No`
HEATING SYSTEMS
Quantity: �
Make: �-�1-P�Y+^�
Mode1: YL I�CLI:1 , -Z�,T�
Fuel: r"'�_ _ '
Flue Siae:
�n
Input BTUs: �(�����
�
Output BTUs: �I�I�GO�D' �
CFM: "i to✓l� '
COOLING SYSTEMS �
Q��'- � ' ,
Make: YLY�e P�vr`�
Model: �'��.3L y�p�Q�
�
Tons: a'�'�►5 i ,�-�`J;'o/� .:�Zdv�>
H.Power
E'[REPLACES
� Gas Factory Fireplace ! Brand Name: (.�Z.✓1 �-P1L't
❑ Wood Buming Fireptace �
❑ Wood Stove Model No.:
❑ Wood Stove With Flue
VENTiLATION
❑ 'Ao: Kitchen Exhaust duct recirculaRiag cfm
❑ To. Bath Exhaust(rnust have duct outside) cfm
0 ho. Other Fans: Locations cfm
FUEL STORAGE {MWst be approvcd by Fire Marshall if prop�ing to abandon[ank in plac�)
0 Installation � � Removal
Fuel Oii: gallons ❑ Underground �Inside � Outside
LP Gas: gallons
Oth�:
G.4S LINE O�IY.Y
❑ Outdoor Grill � Other/L�st What&`Vhere:
2
�C�a� r��3�.C�:� 3� ���—� �,�.�G-�- ��v'k-.
�
May 06 10 10,28a TONKA PLUMBING 952-472-9220 p.4
. , . " , , ' , .
PERMIT FEE CALCUI,ATION(S)
BASED OFF -2002 ST �TE STATUE
❑ Yes,this section applies
The replacement of a Residentia!fix�ture or a,ppliance that meets all three of the following rec{uiremen�s:
1. oes aot require modifica�ion to electrical ar gas service.
2. [ias a�nf$SOO.OU or[ess;exc u in the cost of the fixture or appGance:and
3. Is improved,installed or repiaced by the homeowner or li¢ensed contractor,
� ,
Skip next section,if this applies; Cost of Permit $ 15.00
Sta�e Surcharge $_��
Mai1-ln Fee(If Applicable) $ 2.00
Totsl Permit Fec $
PERMI'�FEE CALCULATION S —JOBS O $500.00
,
If above does not apply;follow guideliaes below:
1. CONTRACT PRICE * is 1.25%of:coutract�rice with a(Minimum Fee of 550.00)
73:��=� x.O125S
(contract p�ice) (mininsum 550.00)
2. STATE SURCIiARGE »'�Add the Sta�te Bldg Code Div. Surcharge(Minimum Fee oiS.50)
• ��►�� � x.0005 S
(contract Pnce) (minimum$ .50)
,
3. POSTAGE&HANDLING(Only on Mail-In Applications) S 2.00
4. TOTAL PERNIIT FEE(Ac�d Lines l-3 Above)' ' S
■ * CONTRACT PRICE or JOB COST means the actual or estimxted dollar amount charged for the
perntitted work including materials, labor,profil,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 ovmer,tenant or any other pariy,the reasonable market value of such items must be add�d to the
estimated cost ar contract price for pem4it fee purposes. In the event that there is a dispute on the
amount of tbe job cost,the Ciry may request tfie submLssion of a signed copy of the actual coMract.
• **The STATE SURCHARGE is.0005 of the Building De�farcment at(952)249-4600 for the prive.
MEC ICAL PERMIT APPLICATION AGREEMENT
The ufldersign� hereby applies to the City far,issu�nce of a Mechanicai Permit, agre�s to do all
work in s�tirict accordance with the ordinancies of the City and the regulations of the State of
Ivlinnesota, and certifies that all statements made,on tlus appl'ecation aze complete, true and
correct �
Applicant's Signature: ��:� �
Reset Form � `
3
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May 05 ;0 10;27a TONKA PLUMBING 952-472-9220 p.1
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265 County Road 1 l0 �€orth. Mouncl, l��i�J 55364
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