HomeMy WebLinkAbout2011-00003 - mechanical � CITY OF ORONO PERMIT NO.: 20��-00003
2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE IssuEn: OUO3/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 1980 SIXTH AVE N
PIN : 27-118-23-42-0004
LEGAL DESC : UNPLATTED 27 118 23
: LOT 000 BLOCK 000 -
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 9,200.00
NOTE: HEATING SYSTEM
(1)CARRIER,MODEL#58MXB040,NATURAL GAS-2"PVC.40,000 INPUT,38,000 OUTPUT,600 CFM
COOLING SYSTEM
(1)CARRIER,MODEL 24 ACB318, 1-1/2 TONS
(1)BATH EXHAUST-75 CFM
APPLICANT MECHANICAL 115.00
DITTER INC. STATE SURCHARGE MECH(VALUATtON) 5.00
820 TOWER DRIVE
MEDINA, MN 55340 MAIL-IN FEE 2.00
(763)478-9558 TOTAL 122.00
PAID WITH CC# 3352
OWNER
PIERPONT,JUDY&JIM
1980 SIXTH AVE N
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed acwrding 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 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 1 SO 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
revoke t any time for due ause.
/l O� (,�GL /D�l //
Applicant Permitee Sig ature Date Iss By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
01i93i2011 I 11:27 DITTER INC � 9522494616 N0.238 D62
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's`-��''�` City of Orono FOR CI7'Y[f66 ONLY
���$�`r P.O.BoX 66 Dace Receivzd; Permit�
r�a�4;.., �� 275U K�IICy PPflcwAy �
; ��r*�'= Cryeml 6ny,MN 55323 Approved 8y; Amount S:
� •'r,��.��t�,� Phone(952)?49-460U Pnx(95'3)249�4C+Ib
`��:.;,�f�
� CTfY OC Ox20N0—1VI�CHAIYICAL PERMIT
(All Commerci�l parmi�s muu�6e upprovcd hy the puilding f�cial o�Inspamr and/or Pire MarshnU)
G�NERAL i]VFORMAI'YON
1. 'You may apply for mechenicol permits by mail ar in person ai the City offices. Applications wi(I
, be reviewed and a permit wil]be issued withio two wo�king days.
2. Permic cards will bo sent by return mail after a rerriev�r is completed. PLRMITS ARE NOT
� YAL[D UNTIL YOU RECBNE A��RMCT. VNOAK MUST NOT BEGIN UNTTL THE
PEA1W(iT CA�lU YS POIS'1'�p QN xHE.1dB SITE.
3. Mecha i I Desi s—Complete calculetions,decails and speciFcatians are requi�ed for each
ating, entilation,humidi�cation-dehumidification,�d air conditionin�installation including
hettt loss/heat gain calculation,desi6m temperotutes,equipmon!rotings snd ideotification as to
rypc,manufacturer and rnodel. Data sliall be pi�esenzed on form provided.
4, when any new consm,stion nr remodelinb is involved,a separate building peamit must be
I obtained.
5. All work rnust be done in accordaoce With tFxe Uniform Mechanica]Code/State Building Code
requiremenu.
G. All work must be inspected(raugh-in and final). Call(952)249-4600.
(24-46 hour n�ticc r�quired)
7. FCouse FXeating Test Record must be submitted 6efore final.
'rvp�or'�°ERMIT
Cneck A�I Tnat a �
�e5identisl �Commercial(Approv�l Required)
�,1Vcw �.p►dditional ❑Repaics ❑Replace
Job Site/O er Infarmation:
Site Address: �
Owner: � 1V�ailing Add�ess: �Q
' City: Zip: �����
Hon�e Phone: �_G�'����J��Alternate Phone:
Contractor Iiiformation:
. �
Contractor: � � ( ' on�erso�: �Q,,,(����i�
�
Address: ���, ���� �; State�ond#: �� fo �� 0�/�
City: ��'�� �1?��xpiration Uat�= $"� �- a o//
PNone: � f �� Alternatc Phone: � J3
/
�` Insurance--CuRent:
1
01iO3i2011 11:27 DITTER INC � 9522494616 N0.238 D03
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� ������~°'��' �1�1���� : '�IyLA�'���&�'���°;�����INSTA�T��.� ;�:���;;
Notc:All Geothermal 5ystems wil)now require a Site Plan&Review by our�uilding OfFicial.
1S THl3 CCOTHERMAL? ❑Yes �No
H�ATINC SYSTEMS
Quantity;
,
M�:c:
Modeh ���x �{�
�uel: ��
i'lue Size: a' �v Y �
lnput BTUs: U
o�ut�rus: �S, 0 DO
cFM: (0� G l�
coo�.rNc svsr��rs
Quantiry;
tvta�ce: G�,r�r 1 pLr
Model; ��
Tons; 4��
�
}-1.Power �
F�I�F pTaACCS
Gtu Factory Fireplace H�and Name:
Wood Buming Firepl�c:e
Wood Scovc lvZodel No.:
Woocl Stave With Rlue
V�NTILAT.ION
No. Kitchen Exhaust duct recirculaLing cfm
No. �_ Bath Exha�st(must have duct outside) ��cfm
No. Olher Fans: i.ocatiaos cfm
FUGL STaRAGE (Mu.rl be approNed by�7re hlr�rshtdl lf proposing eo aDairdon tarel�ln pdnce.)
' � Installation � Removal
Fuel Oil: �allons ❑ Unde.rground ❑ fnside ❑Outside
LP Ga3: gallons
Ofl��r:
GAS LiNE ONLY .
� Outdoor Grill � Other/List What&Where:
2
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01iO3i2011 11:27 DITTER INC � 9522494616 N0.238 D04
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� � � .: P�R1�1�T�>�����.,,�u.AT[O'�1(�),
�AAS,Rl��'�:FF�2QR2�`��'ATE,�T��`rI;J.E ; �
� V'es,this secuon applies
'the replacement of e Residcnti�l f xturc or appliance th�t meets�II three of ihe foUowing requirements:
1 1. .Dues not require modification to electric�l or gAs scrvioc.
2. Hes a ta cost of$500.00 or Icss;excludin the cost of the fixture or applianco:and
3, Is improved,installod or replaeed by the homeowner or licensed co�tractor.
Skip�cxt 3Cction,ifthis spplieS; �ost of Permit $ 15.00
State Surcharge $ 5.00
I Mail-In Fee(IfApplicable) $ a.ao
Tptal Pecmit Fee $
� � l��t?F� '`:1:�'::�?���� �S�ALCUS:�AT101�,5��-JOB�a 0�1Ebt �qQ:QO
rf above does not apply;follow guidelines below:
1. CON�'�4CT PRrC� ' is 1.2�0 of contrect price wirh s(Minirnum�ee of 550.00)
_�� x.0125$ ) �� �
(contract�rice) (minimum SSP,cK1)
�. STATE SURCHARC� **Add the S[ate 131dg Code Div.Su�charge(Miaimum�ce oPSi.OU)
x.aoos s ��
(conanM price) �minimum 3 5.00)
3. PO5T�1G�&HANbLINCr(4nly on Mail-ln Applications) $ ?00
4. 'fOTqY.P�R�MY'1'��(Add Lines t-3 Above) $ `��f
• " CONTRACT PRfC� or JOB COST means the actual or estimated dollar �unount charged for the
1 permirted work includiog materiols, lobor,pro�"it,flnd other fixed eosts. It is the amount[o be charged
to che customer for the work done, lf any materi9l, equipment, labor or installations fue furnished by
�he owner,tenent or any othcr party, the reesonable market value of such items must be added to the
estimated cost ar convacl price for pormic fee purposes, ln tha even� that there is a dispute o�� the
smaunt uf the jab eosl', che City may request the submission of a signed copy of the aetuel contrac[.
� "The STAT&SURCHARGE is.0005 times the Conuact Price or a mini.mum of a5.00.
�1,�����,:��� N��''..'�;'.P�,�RIVf�:�" � �'��'P'f,..iCAT�.C�N:,�GR��MENT
I The un�ersigned hereby applies to the City for issuance of a Mechanic�l Permit, agrees to do all
wo�k in strict accordance with the ordinances oF the Ciry and Che regulations of the State of
Minnesota, a,�d ceirtifies that all statemenu made on this application ar� complete, true and
COr�Cc�.
1
Applioant's Sigr►ature: � 13ate: '� f
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Res�l�`Fi�'i: 3