HomeMy WebLinkAbout2015-00545 - mechanical CITY OF ORONO * 2 0 1 5 - 0 0 5 4 S *
� 2750 KELLEY PARKWAY DATE ISSUED: OS/06/2015
ORONO, MN 55356-
� 952 249-4600 FAX: 952 249-4616
ADDRESS : 1420 SHORELINE DR
PIN : 11-117-23-22-0015
LEGAL DESC : DRAGONFLY HILL
: LOT 002 BLOCK 001
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : GAS LINE ONLY
VALUATION : $ 900.00
NOTE: GAS LINE FOR A GENERATOR
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 0.45
SELECT MECHANICAL SERVICES INC. MAIL-IN FEE 2.00
6219 CAMBRIDGE ST
ST. LOUIS PARK, MN 55416- TOTAL 52.45
(952)926-4488 Payment(s)
CREDIT CARD 8605 52.45
OW1vER
FELDSHON, DAVID&ARCHELLE
1420 SHORELINE DR
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 the work described and does
not grant permission for additional or related work which requires sepuate
permits. All provisions of Iaws 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 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. �
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Applicant Permitee Signature Date Issued By Signature Date
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Ctity of Orono `�'
�►��� P.O.B�mc 66 DatE R�NCSf:.:;43� ' ���'e�tt�,'. �`��.`<<(�
� � 2750 Kelley Parlcway � ' a �; .�-
Crystal Bay.MN 55323 AP}�rpued$y: '� �� sam4t�t�1'� r`�`J���`,;
Phone(952)249-4660 Fax(952)249-4616
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<.�k s�p��.� CITY OF ORON�—MECHANICAL PERMIT
(All Commcrcial permita must be approved by the Building Official or Inspector and/or Fire MarshaIl)
C� NER�4I. [N1�''(JRM�ITTC1 ;
l. You may apply for mechanical permits by mail or in person at the City o�ces. Applications will
be reviewed and a permit will be issued within two working days.
2. Permit oands wii]be sent by return mail after a review is complebed. PERMITS ARE NOT
VALID UNTII.YOU RECENE A PERMIT. WORK MUST NOT BEGIIV UNTIL THE
PERMIT CARD LS P05TED OLV THE JOB SI'1'E.
3. Mechani�,a1 Designs—Complete calcu[ations,details and specifications are required for cach
heating,ventilation,humidification-dehumidification,and air conditioning in5tallation including
heat loss/heat gain calculadon,design temperaiurea,equipment ratings and identification as bo
type,manufacturer and model, Data shall be presented on form provicl�cl.
4. When any new construction or remadeling is involvect,a separate building permit must be
obtained.
S. All work rnust be done in accordance with the Uniform Mechanioal Code/State Building Code
requiremeMs.
6. Ali w•ork must be inspected(rough-in and fmal). CaII(952)249-4600.
(24-08 hoar nofree reqnired)
7. House Heating Test Record must be submitted before final.
' TYY� �}� PERA�Ii"T `
i +�h�ck Ai�:'That A I �
�Residential ❑Commercia!(Approval Required)
New ❑Additional ❑Repairs ❑Replace
Jc�b-�ite 1 Cfx��et,Tnfc�tm �ion: ;
Si Address: ��L� �horG�h. b,r
O er: �v.c� f=e.to�s�►o� MailingAdciress; G��t� _.n-u sa3�il
c ry: �r�►�� , �a�,� z�p: Ss3�r
H rne Phone: Alternate Phone:
Cqntra�r Tnfu2't�t��s: ;
C�ntractor: ��c�-7 ������.�� ContactPerson: ��2�,�.-� �[�4t,��s
A�ldress: �Zi h G sv�br,�s� S�. State Bond#:
C�ty: S�� I,�c�.;I,�2,-�c Zip:, ;syl{� Expiration Date: _, , _
Pl�one: �''1��� °f2ir- Hy�$ �►lternate Phane;
j ❑ Insurance—Current:
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N t�AI1 Geothermal Systems will now require a Site Plan&Review by our Building O�cial.
I3 TIiIS�GTOTHERMAL? ❑Yes ❑No
TI11TC SYSTEMS
M e:
M del:
F !:
FI a Size;
In ut BTUs:
O tput BTCTs:
C M:
C OLING SYSI�MS
Q UtY�
e:
M el:
T s:
H.Power
❑ Gas Factory Fireplace Bia,nd Name:
❑ Wood Buming Fireptaoe
❑ Woo�Stove Model No.:
❑ Wpod Stove with Flue/Masonry
V N N
❑ Tvo. Kitchen Exhaust duct r�irculating c�m
❑ No. Bad�Fixhaugt(mu$t have duct ou#side) cfxn
❑ No. Other Fans: Locations cfm
E STO GE (Mast be approved by F�re Mersaallllprnpasiltg to abandon da�k in plec�)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Idside ❑Outside
LP Gas: gallons
Other:
G SL O
❑ O�tdoor Grfll � Other I List What&Where: bG+�l tvo�'►�>✓
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Yes,this section applies
e repiacement of a Residentiel fiixture or appliar�ce that maets all thrae of the following reyuiremertts:
1. ces not require modification to electrical or gas service.
2. Has a total c s of$500.00 or less; excluding the cosi of the fixture ar a{�pliance:and
3. Is improved, installed or replaced by the homeowner or licensed contractor.
Skip next sectian,if this applies; Cost of�Permit $ 15.D0
State Swcharge �^ 5.00
Mail-In Fee(If Applicable) $ 2.Ob
Total Permit Fee �
� �x� a.
If above does not appty;follow guidelines below:
1. CONTRACT PRICE "is],25%of contract price with a(Minimum Fee of$50.00)
�Of�. � x.0125$ � �5�.�
i _
(condact price) (meeiroom$5U.00)
2. ST�iTE STJRCHARGE
�P�. � x.0005 $ ,�, '7��
(corrtract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 �
�
4. 'POTAL PERMTT FEE(Add Lines 1-3 Above) S S� ` �1 I
� * CONTR.ACT PRICE or TOB CdST 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 ba charged
, to the customer for the work done. If any material, aquipment, labor or instaliations ai*e furnished by
the owner,tenant or any other parhy, the reasonable markei value of sucU items must be added to the
� estimated cast 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.
��.
T e undersigned hereby applies to the �ity for issuance of a Mechanical Permit, agrees Co do sll
w rk in strict accordance with the ordinances of the �City and the regulations of the State of
innesota, and certifi�s that all statements made on this applicadon are complete, true and
c rrect.
plicant's Signature� � �._� Date: �/S�f� _
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�',5 DATF�� TIME',_�
CITY OF ORONO � CALLED IN
INSPECTION I�QTICE�S� SCHEDULED �
PERMIT NO. L��v COMPLETED
ADDRESS I �z� c�lOr� �/!'L� ��
OWNER TELEPHONE NO.�1�y��
CONTRACTOR �
>; DESCRIPTION � J L/�- ri'"/!� ��
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF P FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB MECHANICAL RI ,j� �y- ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
v ❑ DEMO-SITE
❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
��., COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
W�QNFECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
�NSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-4600
OwnerfContractor on site:
Inspector. 4�� �-- �
White Copyllnspector's File Canary CopyfSite Notice