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CITY OF ORONO PERMIT NO.: Zoiaoo92�
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUEn: 10/04/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 1300 SPRUCE PL
PIN : 08-117-23-32-0016
LEGAL DESC : SAGA HILL REVISED
: LOT 000 BLOCK O10
PERMTT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : COOLING SYSTEMS
VALUATION : $ 0.00
NOTE: COOLING SYSTEM-MITSUBISHI-MSZ-GE15NA
APPLICANT MECHANICAL 50.00
KLEVE HEATING&AIR STATE SURCHARGE MECH(VALUATION) 5.00
13075 PIONEER TRAIL
EDEN PRAIRIE,MN 55347-6 MAIL-IN FEE 2.00
(952)941-4211 TOTAL 57.00
PAID WITH CC# 8868
OWNER
MCLAIN, STEVEN&CHRISTINE
1300 SPRUCE PL
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
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 consuuction 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.
C������ �°� `�� �� /Q � o
Applicant Permitee S�gnature Date Issued Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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�' � City of Orono �� �� � � � ��� 3, �:��, � � ���
� O P.O.Box 66 ���b�lq���' a
2750 Kelley Parkway � t �r�� z "� �
� � Cryetel Bay,MN 55323 ��r;':: � .��„��'y�
(952)249-4600 . . -' .: _ rt
CITY OF ORONO-MECHANICAL PERMTT
(All Commercial permits muat be approved by the Building�cial or Inspector and/or Fire Marahall)
1r7i+1`F��1i�1[',V�2�13�L'Y . .
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. Pemut 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
PERNIIT CARD IS POSTED ON TI�JOB S1TE.
3. IVIlechanical Designs—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and sir conditioning installation including
heat loss/heat gain calculation,design temperatures,equipment ratings and identi6cation 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 work 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.
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�2esidential ❑Commercial(Approval Required)
❑New �Additional �Repairs �Replace
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Site Address: �� �rU�. �aCQ,
1 � J �
Owne • � � I"1 �� Mailing Address: �'��l I�L�
City: Zip:
Home Phone: Alternate Phone:
�'.,�i',' �: _
Contractor: �eve Heating 8�AC Contact Person: �hley Griffin
Address: �3075 Pioneer Trail State Bond#: �'I��I b I I I
City: Eden Prairie Zip: 55347 E�cpiration Date: 08/14/09
Phone: �952�94�-42�� Alternate Phone: �952)345-7242
✓Q Insurance-Current:
1
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Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTIiERMAL? ❑ Yes �No
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
�,tiri� 1
Make: I IT�jc u� 1
Model: — �s�
Tons:
H.Power
FIItEPLACES
❑ Gas Factory Fireplace � Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove With Flue
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfin
❑ No. Bath E�chaust(must have duct outside) cfm
� No. Other Fans: Locations cfm
FUEL STORAGE (Must be opproved by Fire MarshaU ifproposi►ig to abandon tank in place.)
0 Installation a Removal
Fuel Oil: gallons ❑ Underground �Inside �Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill � Other/List What&Where:
2
PERMIT FEE CALCULATION(S)
_� ______ BASED 4FF_20n2 STATE STATUE _
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
]. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludinu the cost of the fiature or appliance: and
3. Is unproved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cosi of Permit $ 15.00
State Surcharge $ 50
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
�'ION S —IOBS OVER 5500.00
If above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1. 5%of contract price with a(Minimum Fee of$50.00)
(� oa 4d
. x .O125$ l�o`
(contract price) (minimum$50.00)
2. STATE SURCHARGE •' A the State Bldg Code Div. Surcharge(Minimum Fee of 5.50)
G� ` ��
x .0005 $ �
(contract pnce) (minimum$ .50)
3. POSTAUE&HANDLING (Oniy on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines I-3 Above) $�JCJ�
■ ' CONTRACT PRICE or JOB COST means the actual or estunated 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 matenal, 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 pennit 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 Depar[ment at(952)249-4600 for the price.
MEC�±C�:�CAL PEItA+�IT APPLIGATION AGREEMENT -
The undersigned by applies to the City for issuance of a Mechanical Permit, agrees to do all
work in strict ccord e with the ordinances of the City and the regulations of the State of
Minnesota, d certifies at all stat ts made on this application are complete, true and
correct.
Applicant's � nature: Date: (f` � v
—�- - �
Reset FormU
3
G� �t/� �r QAT�� TIME , /
CITY OF ORONO CALLED IN ��
INSPECTION NOTICE SCHEDULED �
PERMIT NO. e2010— ADg Z � COMPLETED
ADDRESS I�J�O ��r�'�-Q ��
OWNER _����d�� /�'LC.�-�-+1TELEPHONE NO. �2 �7� 12�3
CONTRACTOR ��-�.��c�`C.
� DESCRIPTION ����'� �
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ � DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ MBING RI ❑ FOUNDATION/REMOVAL
Q OWNE ONTRACTORTO EEfYOU: YES NO
y COMMENTS:
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� ❑WORK SATISFACTORY:PROCEED J`�PROJECT COMPLETE
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W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CARRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC�/ERING PERMANENT
�CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑IWSPECT�ON REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (g52) 249-460�
Owner/ConUactor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice