HomeMy WebLinkAbout2016-00016 - mechanical CITY OF ORONO * Z 0 1 6 - PJ PJ 0 1 6 *
� r �' 2750 KELLEY PARKWAY DATE ISSUED: 03/14/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3607 SHORELINE DR
PIN : 20-117-23-21-0029
LEGAL DESC : TOWNSITE OF LANGDON PARK
: LOT 007 BLOCK 007
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 3,000.00
NOTE: SEPARATE PERMITS REQUIRED: ELECTRICAL(STATE)
SOLAR PV INSTALL
APPLICANT MECHAN[CAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.50
ABLE ENERGY MAIL-IN FEE 2.00
265 MANDVIEW RD
RIVER FALLS,WI 54022- TOTAL 53.50
(715)621-9335 Payment(s)
CREDIT CARD 0969 53.50
OWNER
WAGNER, STEVAN&DEBRA
5440 MORNINGVIEW CT.
MOLJND, MN 55364-
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
no[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 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. ��^
,�
�` ,
` ;� , 2� � 7� j �� t �,-
�
Applicant Permitee Signature Date [ssued By igna�ire Date
w
i
s
�
f '
I r '
ty � ���,� dODI�
Ci of Orono
P.O.Box 66 Dak Raeived; etmitlE;;�
��O 2750 Kdley Pukway
Crystal Bay,MN 55323 Approved8y; AmrnmtS„�,�. ,� �I�
Phone(952j 249-4600 Fa�c(952)249-4616 � � Y
� �
l
y
�<'�k�SHo�`�'`` CITY OF ORONO—MECHANICAL PERMIT " Y�`��� �iI4'
(All Commcmc�el peimits mwt be approved by the Bwldmg Officiel�Iaspector end/or Fue M�ahall) �
G�W�'�RMATI(?N ' 'i� : O
� �/V �
1. You may apply for mechanical peanits by mail or in person at the City offices. Applications vJii!
be reviewed and a pertnit will be issued within two working days.
2. Pemtit cards will be sent by retum mail after a review is completed. PERMIT'S ARE NOT
VALID UN1'IL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERNIIT CARD IS POSTED ON THE JOB STTE.
3. Mechanical Desi,�s—Complete calcu(ations,details and specifications are required for each
heating,ventilation,humidificarion-dehumidificarion,and sir conditioning installation including
heat loss/heat gain calculation,design temperatures,equipment ratings and ide�ati5cation as to
type,menufacturer and model. I�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 accotdance 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 hoar notice requircd)
7. House Heating Test Record must be submitted before final.
'; : TYPE OF PERMIT '
Check All That A 1
❑Residential �Commercial(Appmval Required) SQ`(�C � � .1.��"
❑New ❑Additional ❑Repairs ❑Replace
Job Site/t3�vner Tnformation:
Site Address: ��� ( ��U���\`�'. \��
Owner:���- W���� Mailing Address: ��1���a�L��Z.U�
city: w��Zia,�� zip: ���`
Home Phone: �� `1�'��� Altemate Phone:
Contraetor Information: i
� ��� � C�.
Contractor: � ��LC ContactPerson: �v I !V 1��� N� � ��,
" �o�����. R� � + �-�'�
Address: i State Bond#:
City: ��u��`�� Zip.���u�'Expiration Date:
Phone: ��"b�' '���� AltematePhone: ���� � V���1
❑ Insurance—Current:
1
,
.
�
., ....
l �iP'� 34'Lp�H'''.. ����;�fi� _ S ;}
Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes �[No
� �
HEATING SYSTEMS
Qu��'�
Make:
Model:
FueL•
Flue Size:
Input B1'Us:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIRF,PLACES
❑ Gas Factory Fireplace Brand Na�:
❑ Wood Buming Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen Exhaust duct recirculatmg cfrn
❑ No. Bath Exhaust(must have duct outside) c&n
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be opproved by F'ue Ma�shaU ijproposixg to abandon tank in place)
❑ Installatioa ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Olher:
GAS LINE OA'LY
❑ Outdoor Grill ❑ Other/List What&Where:
2
--------�
�
�r ` � � � .y_
���,„�, ������� � '
❑ Yes,this section applies
The replacement o esidenrial fu rc r a lian thai mcets all three of the �ig requirements:
1. Does not require 'ication to electrical or rvice.
2. Has a total cost of 5500. the cost of the fixturo or appliance:and
3. Is improved,installed or re I is omeowner or licensed contractor.
Skip next se ' ,if this applies; Cost of Pertnit S 15•00
State Surcharge S 5•00
Mail-In Fee(If Applicable)
, Total Permit Fee S
41 Ik'`��� '
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimnm Fee of 550.00
3, Un� X.0�25�
������� �.��m�m sso.ao�
2. STATE SURCHARGE
x.0005 $
(contisccprice)
3. POSTAGE Bc HANDLING(Only on Mail-In Applications) S 2.00
4. TOTAI,PERMI7'FEE(Add Lines 1-3 Above) S
■ *CONTRAC'f PRICE or JOB COST means the actual or estimated dollaz amount charged for the
permitted work including materials,labor,proSt,aod other fixed costs. It is the amourrt to be charged
to the customer for the work done. If any material,equipment,labor or installations are fumished 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 fce purposes. In the event that there is a dispuLe on the
amount of the job cost,the City may request the submission of a sigued copy of the actual contract.
i��ti°:
T'he undersigned hereby applies to the City for issuancyjof a Mechanical Permit,agrees to do all
work in sirict accordance with the o ' ances of�'City and the regulations of the State of
Minnesota, and certifies that all,�te ents �qde'on this applicarion are complete, true and
cortect. /1
, /I f �
, �;/'��� /� �e j.� ; I/�' ���j L
Applicant s Signature: �; (�' F� DaTe. i� " i G"�' �
3