HomeMy WebLinkAbout2008-P11941 - mechanical y PERMIT
• �ITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P11941
Crystal�ay, Minnesota 55323 Permit Type:
Mechanical Permits
(952) 249-4600 Date Issued: 3/28/2008
SITE ADDRESS: 140 Sxnith Ave Unit#
Wayzata,MN 55391
PID: 02-117-23-21-0028
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Mechanical Permits Permit Sub-type(s): Multiple Mechanical Items
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Pernrit Fee: $ 135.00 valuation: $ 10,800.00
State Surcharge Fee: $ 5.40
Misc.Fee: $ 1.50
TOTAL FEE: $ 141.90
APPLICANT: Sedgwick Heating&Air Cond Inc. OWNER: Thomas Hunt
8910 Wentworth Ave S 140 Smith Ave
Minneapolis,MN 55420 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
.
APP�ERMI�IGNATURE LC}r'�v
UED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, I-Septic) Page 1
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' �,���a City of Orono :
P.O.Box 66 Date Recerved . `Permit#.
� 2750 Kelley Parkway '
� �'"� Crystal Bay,MN 55323 Approved By: Amount'$
,�o# (952)249-4600
CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
GEI�ERAL;II�Fl:�RIv1ATI0�1
1. You may apply for mechanical permits by mail or in person at the City o�ces. 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 UNTII.YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desiens—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 en form pro�zded.
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 work must be inspected(rough-in and final). Call(952)249-4600.
(24-48 hour notice required)
�. House Heating Test Record must be submitted before final.
' TYPE OF PERiv1IT
, Clieck A�:Tliat A 1�
�Residential ❑Commercial(Approval Required)
❑New ❑Additional ❑Repairs �teplace
3oU,Site/Owner Inforrriat�on.-:'
Site Address: _��10 S11n�� �,� �
Owner:TtSm '�.✓1�' Mailing Address: ��I� S�M�'C� �l�-2
city: O✓t�r�e� zip: S S 3�i (
Home Phone: `�'S 2 -�1 S—Z S,.S Z Alternate Phone:
�ontractor Tnfor�natic�n: -
Contractor: Contact Person:
SEDGWICK HEATING&AIR CONDITIONING LLC
Address: State Bond#:
Minneapolis, MN �420
City: �p: Expiration Date:
Phone: Alternate Phone:
❑ Insurance—Current:
1
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HEATING SYSTEMS
Quantity: �
Make: � Q_Nl �'i C� x
Model: ��I►Ll1�V 60C_ O�j �
Fuel: ��-S
Flue Size:
Input BTUs: �r6�
Output BTUs: ��,�IS b
CFM:
COOLING SYSTEMS
Quantity: �
Make: 0 C .
Model: XL-l� ��Z
Tons: �
H.Power
FIREPLACES
❑ Gas Factory Fireplace
❑ Wood Burning Fireplace
❑ Wood Stove
❑ Wood Stove With Flue
Brand Name: Model No.:
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) � cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL)
❑ Installation ❑ Removal
FueI Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Griil ❑ Other/List What&Where:
2
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
i. Does not require modification to electricai or gas service.
2. Has a total cost of$500.00 or Iess;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 $ .50
Mail-In Fee(If Applicable) $ 1.50
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$35.00)
�
1�, �,00 . �o X.o�2s$ 135 � ob
(contract price) ' (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$.50)
��0� 8 OC7 •Oc� x.0005 $ S' � v
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �� �� / b
■ * 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 pariy,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.
■ **The STATE SURCHARGE is.0005 of the Building Department at(952)249-4600 for the price.
�.. ,
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 statements made on this application are complete, true and
correct.
Applicant's Signature: Date: 3 0�'s
CSL--
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DATE TIME ✓
CITY OF ORONO CALLED IN J��l�-D� �
INSPECTION NO SCHEDULED o-
PERMIT NO. COMPLETED
ADDRESS ��� S�'��i �'��
OWNER CONTR.�„��C.cJCC,��
TELEPHONE NO. 9�Z �7� aS�S Z
� DESCRIPTION � � �
� ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
c�., COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE
W ❑CORRECT WORK&PROCEED ❑ SUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WFLL REfURN
❑STOP OROER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on sit :
Inspector. ��1 /
White Copyllnspector's Ffle Canary CopylSite Notice
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOBNO. - "' O
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS,MN 55420 • (952)881-9000 TEST RECORD
ADDAESS �� � �/'Vv�y� , V — CITY �� � v
OCCUPANT OWNER 'r ` � �n'
SOLD BY "��n�'� `� �"/ �� INSTALLED BY
MAKE ��� MODEL ��C� � I " 'U ��" �—`� � �
SERIAL NO. 4 INPUT ��k ���`
�/ " JC
THERMOSTAT v r �� � VENT SIZE � �
^
VALVE TYPE OF LINER
� �
LIMIT LINER SIZE
LIMIT SETTING O FILTERS: SIZE� y' NUMBER
� ��b�r Q� � �PC •
FAN SETT'ING WIRING �
� I,
PILOT TYPE � G n TEST TAG �
�
IGNITION MODEL LIGHTING INST.
PILOTTIMING ' '��� ^�'V
1 0 DATE TESTED
PRESSURE ✓ � PERCENT CO2 \ /
U COMPANY TESTING �� `
INPUT CFH PERCENT OZ
STACK TEMP. PERCENT CO � NAME OF TESTER `�
FORM 235(REV.11/89) FORM DISTRIBUTION: WHITE COPY-JOB FILE YELLOW COPV-CITV