HomeMy WebLinkAbout2016-01549 - mechanical r �
- CITY OF ORONO * 2 0 1 6 - 0 1 5 4 9 *
2750 KELLEY PARKWAY DATE ISSUED: 12/19/2016
ORONO,MN 55356-
(952)249-4600 FAX: 952)249-4616
ADDRESS : 1245 SIXTH AVE N
PIN : 26-118-23-34-0007
LEGAL DESC : AUDITOR'S SUBD.NO.291
: LOT 000 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTI01�1 TYPE : HEATING SYSTEMS
VALUATION : $ 16,875.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
(1)NTI NATURAL GAS FURNACE
4"FLUE
250,000 INPUT
235,000 OUTPUT
APPLICANT MECHANICAL 210.94
STATE SURCHARGE MECH(VALUATION) 8.44
SELECT MECHANICAL SERVICES INC. MAIL-IN FEE 2.00
6219 CAMBRIDGE ST
ST.LOUIS PARK,MN 55416- TOTAL 221.38
(952)926-4488 Payment(s)
Minnesota State License#:mech-MB003390 CHECK 4265 22138
OWNER
HOGAN,JOHN&KIMBERLY
1245 SIXTH AVE N
LONG LAKE,MN 55356-
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 dces
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 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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C�(.c�C�e-l�- � /
Applicant er►nitee Signature Date Issued By gnature Date
� w - RECEIVED
DEC 1 9 2 16 ' FO C1TY SE ONLY �
City of Orono 19 �i /�/� J�
'g.0� P.o.Box 66 Date Received: //pertnit# � /
� 2750 Kelley Parkway v�B p�ount S: �a� � �
Crystat Bay,MN 55323 CITY OF OR y�
phot�e(952)249-4600 Fax(952)249-4616
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y��'kFSHo4``L, CITY OF ORONO—MECHANICAL PERMIT
(All Commemcial permits must be approved by the Building Official or Inspector and/or Fire Marshal])
GENERAL INFORMATION
1. You may apply for mechanical pernuts by maii or in person at the City offices. Applications will
be reviewed and a permit will be issued within two working days.
2. Pecmit cards will be sent by return mail after a review is completed. PERMITS ARE NOT
V,�I,ID UNTII.,YOU RECENE A PERNIIT. WORK MUST NOT BE(�IN UNTIL THE
"�D:""T CARD IS POSTED ON TI�JOB STTE.
3. Mechanical Desisns—Complete calculations,deta�ls and specifications are required for each
heating,ventilation,humid�carion-dehumidification,and air conditioning installation including
heat IossJheat 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. Aii work must be done in accordance with tt►e Uniform Mechanical Code/State Building Code
requirements.
6. All work must be inspected(rough-in and fmal). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
Check All That A 1
�'Residential ❑Commercial(Approval Required) [Backflow Device: ❑AVB ❑PVB]
❑New ❑Additional ❑Repairs ❑Replace
Job Site/Owner Information:
Site Address: �Z`"�� �"'���'��"�� �`'°""'�`�� �n
Owner:.�c�N� ���+��' _ Mailing Address: �°�.`�-�� �:-"�'"�' 1"�� �
City: ���+�J� Zip: ������� _
Home Phone: �o�Z'���`���� Altemate Phone:
Contractvr Information:
Contractor. ��""4' ��'���al���� Contact Person: ���� '•���"��aY��
Address: �i� �'��^������`:��'*�� �� State Bond#: M�d�����
City: ST �-�+.� �i� - Zip:�'"'� Expiration Date:
rN.. �y rn N+ �'J �t � J=V
Phone:
�'.��-'���'����c�4 Alternate Phone: ,s�,��- �`��,m � � ,a `.�
❑ Insurance—Current:
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�r;Y„;xre;�.5'.b�`"�F�,�.+.�s�yf,,�tL�i�,��,;��r��"'� '�k" "�
1. CONTRACT PRICE * is 125%of contract price with a(Minimum Fee of$50.00)
� ��, ��'i� X.oi2s$ �—�D � �' �l
�(contract price) (minimum$50.00)
2. STATE SURCHARGE � �� ��� x.0005 $ �r `���
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2•�
4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) $ �'Z t '��
• * CONT'RACT 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, tenar►t or any other party, the reasonable market value of such items must be added to the
estimated cost or conuact price for�ermit 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 City for issuance of a Mechanical Permit, agrees to do all
work in strict accordance with the ordin f the City and the regulations of the State of
Minnesota,and certifies s t ma on this application are complete,m�e and correct.
.;�^"
Applicant's Si Date: ��""��"�!�
3