HomeMy WebLinkAbout2017-00919 - mechanical � _ � CITY OF ORONO * 2 0 1 7 - PJ 0 9 1 9 *
2750 KELLEY PARKWAY DATE ISSUED: 08/07/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952 2�9-4616
ADDRESS : 2160 SHEVLIN DR
PIN : 03-117-23-34-0019
LEGAL DESC : WEBBER HILLS
: LOT 002 BLOCK 003
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : COOLING SYSTEMS
VALUATION : $ 2,000.00
NOTE: (1)DAIKIN 3 TON A/C
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APPLICAINT MECHANICAL 50.00
RIVER CITY SHEET METAL INiC. STATE SURCHARGE MECH(VALUATION) 1.00
8290 MAIN ST.NE MAIL-IN FEE 2.00
SUITE 39 TOTAL 53.00
FRIDLEY,MN 55432 Payment(s)
(612)754-2199 CHECK 13292 53.00
Minnesota State License#:mech-003364
OWNER
LARSON,MR.&MRS.
2160 SHEVLIN DR i
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,tpplicable City approvals,and the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or�elated work which requires separate
permits. All provisions of laws and orbinances governing this type of work
shall be compied with whether or not pecified herein.This permit will
expire and become null and void if co struction suthorized is not
commenced within 180 days of the d of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assur g all required inspections are
requested in conformance with the S te Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Issued By S' ature Date
� . ,, . ' RECEIVED
City of Orono AUO 0 7 2U 17 `�S "° ����°�Y G� q
��� P.O.Box 66 Da�R �' 1� Permit#�� 7� /�/
� 2750 Kelley Parkway ��
, Crystal Bay,MN 553�ITY OF ORON Apyroved By; Amott�t$:�+�"
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Phone(952)249-4600 Fax(952)249-4616 �
t�kESHO��G CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL INF RMAT'ION
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 Desiens—Complete calculations,details and specifications aze required for each
heating,ventilation,humidification-dehumidification,and air conditioning installation including
heat loss/haat gain calculation,design temperatures,equipment ratings and identification as to
type,manufacturer a�id 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
requiremer�ts.
6. All work�ust be inspected(rough-in and final). Call(952)249-4600.
(24-48 ho r notice required)
7. House Hea�ing Test Record must be submitted before final.
TYPE QF FER.MIT
,' Check Alt That A �l
�Residential ❑Commercial(Approval Required) [Backflow Device:❑AVB ❑PVB]
❑New ❑Additional ❑Repairs �Replace
Jab Site/Uwn` Inf�rmation:
Site Address:
Owner: Mailing Address: ���d S�-Q/U 1 � �li V�9 �'�
c�ri: 0 � o � zip: Ss3� �
Home Phone:�S�1 �a� � �(1I�D � �Alternate Phone:
Cantractc�r In rmation:
Contractor: �, Contact Person: ��
Address:�v\� ��`� S� � State Bond#: �� �����,�
City: �C� `� Zip:�N Expiration Date:
Phone: � �� ���c —�-��� Alternate Phone:
❑ Insurance—Current:
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Note: All Geothernlal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes �No
HEATING SYSTEINIS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs: ,
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity: I
Ma1ce: �Gl.l I1�
Model: !J�C� S 1 \� ' 1 �`�
Tons: � �Q�
H.Power
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wdod Burning Fireplace
❑ Wdod Stove Model No.:
❑ Wdod Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfrn
❑ No. Bath Exhaust(must have duct outside) cfin
❑ No. Other Fans: Locations cfin
FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fu�l Oil: gallons ❑ Underground ❑ Inside ❑Outside
LP:Gas: gallons
Otl�er:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
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1. CONTI�ACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
x.0125$ S�.OG
(contract price) (minimum 550.00)
2. STATE SURCHARGE
x.0005 $ I • U�
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL pERMIT FEE(Add Lines 1-3 Above) $ S� .�
■ * 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 hareby applies to the City for issuance of a Mechanical Permit, agrees to do all
work in strict accokdance with the ordinances of the City and the regulations of the State of
Minnesota,and cert�fies that all statements made on this application are complete,true and correct.
Applicant's SignatUre: �—�'a� ate: � [ 7 I I 7
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