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Home My WebLink About2017-00349 - gas line only CITY OF ORONO * Z 0 1 7 - 0 PJ 3 4 9 * `' 2750 KELLEY PARKWAY DATE ISSUED: 04/12/2017 ' ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1480 SIXTH AVE N PIN : 26-118-23-32-0008 LEGAL DESC : DOUGLAS ESTATES : LOT 001 BLOCK 001 PERMIT TYPE : MECHANICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY VALUATION : $ 550.00 NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. NEW:GAS LINE ONLY FOR FIREPLACE APPLICAIVT MECHANICAL 50.00 BOE PLUMBING STATE SURCHARGE MECH(VALUATION) 0.28 15481 KIOWA ST. TOTAL 50.28 ANDOVER,MN 55304 Payment(s) (763)757-1991 CHECK 4508 5028 Minnesota State License#:plbg-PC644079 OWNER GULBRANDSON, DAN&ERICKA 1480 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 specitications,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 separate permits. All provisions of laws and ordinances governing Ihis 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 I80 days at any time after work has commenced. The applicant is resp nsible for assuring all required inspections are requested in confor ance with the State Building Code.This permit may be revoked at any time or ue cau . . �� , � _ :� ;: � �_r_,.�; / --��=�=�- , , , ' � Applicant Perm Signature ate [ssued[3y Signature Date �' � FOR CITY USE ONLY ., �O�O P O o�f Orono Date Received: �� Pennit# ��'� 7�� ' � 2750 Kelley Parkway Crystal Bay,MN 55323 Approved By: � Amount$: ,�(;_ . � Phone(952)249-4600 Fax(952)249-4616 � � � y� � `�KESH��G CITY OF ORONO—MECHANICAL PERMIT (All Commercial pennits must be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL INFORMATION 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 Desi�—Complete calculations,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 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 requirements. 6. All wark must be inspected(rough-in and final). 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 ❑PVBJ �New ❑Additional ❑ Repairs ❑Replace i • Job Site/Owner Information: Site Address: �7 �� . �f Owner: �►�d � � V i�( �r�� ;tn Mailing Address: City: ��JV�,� Zip: Home Phone: Alternate Phone: Contractor Information: , ^ Contractor: �� ContactPerson: / L� Address: �� l�b�v✓� s� State Bond#: City: �� '� Zip: ��iration Date: Phone: �� 7�7 � �� Alternate Phone: ❑ Insurance—Current: 1 �►►. ,�. _ °. M��N��A�:,�YS�'��vl�°�Ei1�TC.� �' .. � � � - .� Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. ~ IS THIS GEOTHERMAL? ❑Yes ❑No HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: Input BTUs: Output BTLJs: CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: H.Power FIItEPLACES � Gas Factory Fireplace Brand Name: Wood Burning Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTII.ATION ❑ No. Kitchen Exhaust duct . recirculating cfin ❑ No. Bath EJchaust(must have duct outside) �� ❑ No. Other Fans: Locations �� FUEL STORAGE (Must be approved by Fire Marshall ifproposing 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: �uJ ��' l,�A�� 2 � .� r PERMIT FEE CALCULATIONS 1. CONTRACT PRICE * is 125%of contract price with a(Minimum Fee of$50.00� -. �� / ` l'L x .0125 $ ��-� (contract price) (minimum$50.00) , S`i 2. STATE SURCHARGE > x .0005 $ - C �� (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.� r ;� t��7 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ `'�� ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the perniitted 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. MECHANICAL PERMIT APPLICATION AGREEMENT The undersigned hereby applies to the City 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 all tatements made on this application are complete,true and correct. , Applicant's Signature: � Date: � �� 3 C- � ,� � J � (/i� DATE TIME CITY OF ORONO CALLED IN —�--� INSPECTION NOTICE SCHEDULED -�� —�-_=�s-% PERMIT NO. •^{� �-L t�y� COMPLETED ADDRESS � /��!X�"�7 �� 7�3 ^. � �:. OWNER TELEPHONE.NO. ��' -� � ��"7�,� CONTRACTOR �'� � �m� • _ � � DESCRIPTION ��-'� f �� t'�/� IC�S 7 `� � ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL �%� Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLIN(3 O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL �� Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT � ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ S PTIC INSTALL 2 01NNENCONfTRACTOR TO MEET YW:�YE8_NO /( � COMMENT'� —' � � � ' � -�� inP �� T� �C.7 r�Si � �C�'.E�� . ' � � �.'.r�/? v O r W � Q � 2 W � W � � W WORK SATISFACTORY:PFiOCE ❑PROJECT COMIPLETE � OORRECT VMORK 8 PROCEED ❑ISSUE CERTiF1CATE OF OOCURANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CONERINO PERMANENT ❑CORRECT UNSAFE CONDITION WRHIN HOURS. p pHpTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ��TATION ISSUED ❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS. Cafl for the next inspectfon 24 hours in advance. (g52) 249-4600 OwnedContractor on site: Inspector: /�'a�/� �- VYhits CopYAnspector's Fil� C�n�ry CoprlSlb Noties