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Home My WebLink About2018-00081 - gas line only T' ,. CITY OF ORONO 2750 KELLEY PARKWAY * 2 0 1 8 - 0 PJ 0 8 1 * DATE ISSUED: OU23/2018 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2780 SHADYWOOD RD PIN : 21-117-23-24-0041 LEGAL DESC : REG. LAND SURVEY NO. 1196 : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY VALUATION : $ 480.00 NOTE: ALL TESTING REPORTS SHALL BE ON S[TE AT F[NAL INSPECTION. GASLINE FOR COOKTOP APPLICANT MECHANICAL 50.00 STATE SURCHARGE MECH(VALUATION) 024 WELTER& BLAYLOCK 1NC. TOTAL 50.24 307 PERSHING AVE.N Payment(s) NEW PRAGUE,MN 56071 CREDIT CARD 5704 50.24 Minnesota State License#:plbg-PM65425,mech-7900379583 OWNER CARTER, RICHARD&JEANNE 2780 SHADYWOOD RD EXCELSIOR, MN 55331- 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 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 f due cause. � � � � / , ,�, / _ Appli nt P mit Si ature Date Issued By Signa re Date , �' FOR CITY USE ONLY f` s �O� City of Orono �D/ �}]��/ P.O.Box 66 Date Received: Pern�it# � (/[/C/ O 2750 Kelley Parkway Crystal Bay,MN 55323 Approved By: Amount$: �b.p� Phone(952)249-4600 Fax(952)249-4616 y�jqk� o��.�'�� CITY OF ORONO—MECHANICAL PERMIT SH (All Co�nmercial pernuts must be approved by the Building Official or Inspector 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. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. 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,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 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 fmal. TYPE OF PERMIT (Check All That A 1 �esidential ❑Commercial(Approval Required) [Backflow Device: ❑ AVB ❑PVB] ❑ New �Q Additional ❑ Repairs ❑Replace Job Site/ Owner Information: Site Address: � 7�U �h��dy W�� a Owner: �� C � �t�-�f r Mailing Address: ��Z �� W�� C � City: �k G�.��t r Zip: �5,��f Home Phone: Alternate Phone: �%� 3�S`.�/g,� Contractor Information: Contractor: � T er �I ��C��rl C- Contact Person: ��f� Address: ��J�t�.� � �t� State Bond#: City: ,v��rQ'y� Zip:��/ Expiration Date: Phone: Alternate Phone: �p/07 �� "� �J� ❑ lnsurance—Current: 1 MECHANICAL SYSTEMS BEING INSTALLED � � � '. Note: All Geothermal Systems will now require a Site Plan & Review by our Building Official. IS THIS GEOTHERMAL? ❑Yes ❑ No HEATING SYSTEMS Quantity: 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 duct recirculating cfm ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations �� 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: ui"/1 �� 2 I - PERMIT FEE CALCULATIONS i. CONTRACT PRICE * is 125%of contract price with a(Minimum Fee of$50.00) �/' dv 7�a x .0125 $ �(contract price) (minimum$50.00) 2. STATE SURCHARGE �� l,.. 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 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. MECHANICAL PERMIT APPLICATION AGREEMENT The undersigned hereby applies to the City far 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 11 statements made on this application are complete,true and correct. . p� Applicant's Signature: � �' Date: �^� � �O 3 �� _ � DATE TIME CITIf OF ORONO ��CALLED IN INSPECTION OTICE SCHEDULED �- � � PERMIT NO / COMPLETED ADDRESS � Q �,/ OWNER LEP ONE .��a CONTRACTOR C�� ll�� DESCRIPTION � ��.�Lf' ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL � ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ LATHE ❑ MECHANICAL RI ❑ 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 ? OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS:��S G;tnQ Q�`t'-� 2K � ,� i�4 � �D j O � � O W � Q � � W � j � b�ll►ORKSATISFACTOFlY:PROCEED ❑PROJECT COMPLETE W ❑CORRECT WORK&PROCEED O ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECONERING PEHMANENT ❑CORRECT UNSAFE CONDITION WRHIN HOURS. ❑pHOTO TAKEN INSPECTOR YVILL RETIJRN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 forthe next inspection 2a hours in advance. (g52) 249-4600 OMmerlContractor on site• Inspector: �� ..� White CopyAnspector's File Canary CopylSite Notks