HomeMy WebLinkAbout2014-00846 - mechanical f '� CITY OF ORONO * Z 0 1 4 - 0 0 B 4 6 *
2750 KELLEY PARKWAY DATE ISSUED: 08/06/2014
ORONO,MN 55356-
(952)249-4600 FAX: 952) 249-4616
ADDRESS : 1700 SHORELINE DR
PIN : 10-117-23-14-0014
LEGAL DESC : LTNPLATTED 10 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 5,320.00
NOTE: REPAIR TO EXISTING HOT WATER BOILER- CAP OR MOVE RADIATORS
(1)FAN-80 CFM IN MASTER BATH
APPLICANT MECHANICAL 66.50
STATE SURCHARGE MECH(VALUATION) 2.66
SELECT MECHANICAL SERVICES INC. MAIL-IN FEE 2.00
6219 CAMBRIDGE ST
ST. LOUIS PARK,MN 55416- TOTAL 71.16
(952)926-4488 Payment(s)
CHECK 3666 71.16
OWNER
ETAL,IRWIN JACOBS
1700 SHORELINE DR
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perfortned 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 sepazate
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 after work has commenced.
The applicant is responsible for assuring all required inspections aze
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 Issue By Signature Date
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USE dNLY
�A' City of Orono
<y P.O.Box 66 Date Receiv Perrnit# �� — ���
� 2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By; Amount$:���-,,,,-,�`�'
Phone(952)249-4600 Fau(952)249-4616
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��KESHo��'G CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or]nspector and/or Fire Marshall)
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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 DesiQns—Complete calcutations,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 remodeting 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.
(2448 hour notice required)
7. House Heating Test Record must be submitted before final.
TYFE fJE FE�MIT
Check All'That A l .
�Residential ❑Commercial(Approval Required)
❑New ❑Additional �Repairs �Replace
Job Site t Owner In�ormatio�:
Site Address: I /Q� ��K+� 1-iN� ��t1�
Owner:.�,avl/� C�� Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Con�ct�r Infonmation:
Contractor: �� ��• Contact Person: ��� ��'tia!"��
Address: ��� l LQ�%�� +� State Bond#: �,1-6��3�` �/ /
City: S �l�t� �I.1C_Zip:,���� Expiration Date: � �� ��
Phone: ���' l� � G"G� Alternate Phone: �5�' ��� ��`� �
❑ Insurance—Current: y>rr"� ���Z�
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Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes
HEATING SYSTEMS
Quantity: �ST?� �W�G�
Make:
Model: "1�NI' �� �+� ��i �
FueL•
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantiry:
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 cfin
No. Bath Eachaust(must have duct outside) cfm
No. � Other Fans: Locations /I2, �i,�=yf �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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❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1. Dces not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
,
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If above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
S�ZD � x.0125$ (e�• �
(contrect price) (minimum$50.00)
2. STATE SURCHARGE �320�
x.0005 $ 2•��O
(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 parry, 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 Ciry for 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 s ments made on this application are complete, true and
correct.
Applicant's Signature: Date: � � �
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