HomeMy WebLinkAbout1994-006726 - replace furnace PERMIT
�, C.��Y OF ORONO PERMIT TYPE: - - �
2750 Kelley Parkway- P.O. Box 66 `�"•`�::�:F�'^`���'-:�:��_
Permit Number: ;-;:;�,��.,:;�,
Crystal Bay, Minnesota 55323 � - - '
(612) 473-7357 Date Issued: ,::�;;�
SITE ADDRESS:
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FEE SUMMARY:
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CONTRACTOR: -- � :°_=��. :� � =::'����.� -- OWNER:
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APPLICANT-PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF
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. ��? -:��
CITY OF ORONO APPLICATION FOR MECHAlVICAL PERMTT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323 DEC i ,5 �`�
GENERAL INFORMATION �^^^
1. You may apply for mechanical pernuts by mail or in person at the City offices. Applications will be
reviewed and a pemut will be issued within 2 working days.
2. Pernut cards will be sent by retum 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 Designs - 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. Identification of and specifications for water heating equipment
shall also be 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 473-7357. 24-hour notice required.
7. House Heating Test Record must be submitted before final.
Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification.
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 473-7357.
Please check one: New Addition Repair � Replace
Residential Commercial n
JOB SITE: '� ' j �-c,���S ; i�� Zip:
Owner's Name: L'_� - � � c` eleph ne Number:
Mailing Address: � City: Zip:
Contractor'sName: coaw►�av�. �TelephoneNumber:
ST.LOUIS P
MailingAddress: ��n�,-7 SEavic� s�a-ao�� City: Zip:
SYSTEM DESCRIPTION
HEATING SYSTEMS
Quantity: �
Make: L <
Model: ��1 l�- ���'
Fuel: /� �^S
Flue Size:
Input BTUs: 1 ,"�Y�
Output BTUs: ,�.�C `` �
CFM: rilc.� kE ;��<_�� L�,�"�� �G�y � _�_ �
COOLING SYSTEMS
� Quantiry:
��� Model: —
��
�� Tons:
H. Power
F 1
` �� {�j f ., . � . �
� 1 ��'
.+w.. ��
WOOD BURNING EQUIPMENT
Wood stove with flue
_ . � .� ; �VVood combination or add-on
Factory fireplace with flue
Factory Fireplace (s) Freestanding Masonry
Wood Stove (s) Franklin, other
Brand Name Model No.
Mfgr's Min., Clearances, side , rear , min. flue dia.
Total
VENTILATION
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. Other Fans: Locations cfm
Total
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation Removal
Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or iViinimum Fee 1$�5.t�0) �
�c�:� �, X i.2s � 37- J�
(contract price)
2. State Surchar�e. ** Add the State B�ding Code Division i �G
Surcharge to each permit. ��C�'`��� x .0005 $ �
(contract price)
3. Posta�e and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ L jf�-c� .
* 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 installation 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 pemut 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 contract price under $1,000,000 or $.50 - whichever is
greater. For valuations over $1,000,000 call the Department of Inspectional Services 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 Minnesota
State Building Code, and certifies that all statements made on this application are complete, true
and correct.
Applicant's Signature: / 1 c Cc ��U � Date: Y�I`
Approved By: Date: � o? �
P�,,� � ��� � �Ya�
� HOUSE HEAT�NG TEST RECORD
ADDRESS � " �'�r �� �vu J �" � �D APT. FLOOR CITY SUBURB �""' k�
OCCUPANT OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED BY O� L
Electrical Work By Gas Lins By �5��
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERS �1 �. ¢''
MAKE _ ��� MAKE OF BURNER —
Modsl �' � a � Model
$erial � Max. BTU Rating
INPUT ��� MAKE OF FURNACE
Model
CONTROLS ��
THERMOSTAT H a Plug �^ Vent Size
Valve KIND OF LINER SIZE NONE
Limit Draft Hood Regulator k�•
Limit Setting Filters Size Number
Fan Setting �� �- � Chimnsy Location Inside�0utside
��
Pilot Type l ��� Chimney Construcfion ����
Pilot Make �
Pilot Model $moke Bomb Wiring
Pilot Timing Draft Test Tay
L.W. Cut Off Door Pressu►e Lighti I at.
Prossure � Percent COZ �6 Date Tested � �
Input CFH � Percent 02 Company Testing T
Stack Temp. � Percent CO Name of Tsster
c
Form 235
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NEAT LOS3 CALCULATION9
Weathers�ripi A' ' ' ' Con�truction No. Insulation
Guide How Appl;ed
Window� I Doon Reference Out.Wall lnt.Wall Ceilin` Roof Floor Kind
Ye�- Ye—— l0 19—
Width Height/,3-/7� Fl.) ' • m L.ength Width Height/j-�Z
a ,FI.� . Room Length / �
Windowa and Doors—Crackage and Area Windows an Doors—Crackage and Area
tVldlh HNtht No.ot Lln�al ft. Are• �.� Wldth Hd�ht No.o! Lln�al tt. Ana �� �
No. ot D�ne of pane Ilfht� o[er�ck �Q.tt• No. ot D��• o[Dan• Il�ht• ot¢rack �o•«•
o �,�. �, �;+�� �� �-� G ' �'� � �l
, � �, , � ¢ �. L. � ��''�
3 Zv � J � � , p
r 3 '�- G �-.. �', �
co�F. sc� � � °�:-- <. g-_ rr_ i co�E. e��
In6ltration ,�' In6ltration '�J �}'SS
Glaas G G' Glaas //J r a(a
Exp.wall ' , ,(i Eup.wall� � -/- j '¢��/ �, !
Net exp. wall � O �v ca • Net exp.wall Q� 3% E�
lnt.wall Int.•rall
Ceiling 1'-/. '�J Ce��ing � J��l"' �" ��' 3
FI•�or ' Floor -�//
Total Btu. O 1 Total Bcu.
Required sq. ft. E.D.R. or.q. ina.W.A. Leader area Required aq. ft. E.D.R. or sq. ins.W.A.Leader area
Fl.� /f�j, - Room�Length // Width/ � Height �-..- _ �,� Room I L..ength Width eig t/j-1 i
Windows and Doon—�Crackage and Area , Windows a d Doors--Crackage and Area
Wldth HN�At No.ot Ltne�l It. Aro� Wldth Heltht No.ot Ginnl tt. Are►
No. of Dane ot D��• Ilihl� o[crack W.f�• No. ot D��e ot D��� Il�ht• o[ertek W•tt.
_ /. � �L ��" 2 �. l L '�_ L . � �
G � l
f-�
� �S�' S � ?- , U
Coef. Bcu u�.-- �c' 11-• a � eE. tu
` 0
1n61tntion � In6ltration '
Glast y � � Glas� ��� �G. � •.� •
fsp.wall � ' Exp.wall t ' �
Net e:p.wall �. "� l C� Net exp.wall s 3 b- "��' �G�
[ntrwa I'-�..7 /4�--tJ lot.�wall '�rw....�Le.. � �--0°+^�-
�.�..�
Ceiling' s Ceiling 3 v� v '�
Floor Floor
Total Btu. "�S' ?� Total Btu.
R�qu�red sq. f�. E.D.R. or sq. ins.W.A. Leader area Required aq. ft. E.D.R.or sq. ins.W.A.Leader area
' Fl. ':b,-{�Fr� J►•�tRoom Length� , Width ,z._ Height D-�• � FI. • Room I Length Width Height
Windows and Doors--Crackage and Area Windowa and Doon—Crackage and Area
WIAth H�I�hI No.of Lln�al tt. Area Wldth Hslsht No.ot Lln�al It. Are�
No. ot pan• et D��s IIfAI� ot craek �a.fc. No. ot D«�e ot p�n� If�ht� ot eraek �a.tt.
� � L o G � 3 �-, v
�
` G _ / 7►
Coef. Btu � Ga // Coef. Btu
In6ltration s� � ` r" lnfiltration -U
CJaa / Y r� y.-- Glase G.
Eup.wall � 4'y(o Eup.wall ~ ! 'rt(,.
Net e:p.wall � (p ,�p Net exp.wall � �
Int.wall Int.wall
Ceiling ��u ' ,3 �'�� Ceiling
Floor �v � Floor •
Tota) Btu. � v Total Btu. � � �
Required�q. ft. E.D.R. or sq. ini.W.A.l.eader area / Required sq. ft. D.R. or sq. ins. WA.Leader uea
' Fl. ,t�- oom �Length Wideh ,�. Height ,� F1. - Room I Length - -. .Width$' Height �.•
Windows and Doors-=Cracksge and Area Wiudowa and Doon—Cncka�e and Area '
Wldth Hd�lyt' Ne.ot Lln��l tt. Are4 Wldth Hal�hl No.ot Llne�l tt. Araa
No. of pan• o(D �� �1�ht� ol craek p.(l. No. ot pan� of pan� Il�hu oI arack W«•
/ P--'
Coef. Btu Coef. Btu
1n61tration 3 /V 1n61tration � �
Gla�� l.�4 Glaa /
Eup.wall � . Exp.wall a ,
Net exp.wall C� <p Net exp.wall a" (o
lnt.wall 1��-ws11''�"�-�� �U'--U-�•
Ceiling y- �� Ceiling
Floor y�- 7 y� Floor
Total Btu. ' J Total Btu.
Required�q. Ft. E.D.R. ot�q. in�. W.A.L.eader are� Required sq. ft. E.D.R. or sq. ins.RIA. Leader area
. � • ,
HEAT LOS3 CALCULATi0N3
Weatherstrip� A' ' ' ' • Coastruction No. ln�ulation
Guide
Windows I Doors Reference Out.Wall Int.Wall Ceilin� RooE Floor Kind How Applied
Yes— I�o Yes l�0 19_
Fl. Room Length,3 / Width Height FI.� Room Length Width Height
Windows and Door�—Crackage and Area Windowa and Doors--Craekage and Area
tVldth Helsnt No.of Lln��l tt. Area ,,,���+++/11 Wldth Heltht No.ot Lln�al tt. Araa
No. ot p�ne of D��e ❑�ht• o[erack �0•�t• � No. ot pan• o[Dan• Il�hu ot crack �0.tt.
� �� �
� 1 �
Coef. Btu Coef. Btu
lnbltration In6ltration
Glaas Glas�
Exp.wai � 2 . �I Exp.wall
Net exp. waU _(, /1- Net exp. wall
Int.wall h ,S Int.•rall
Ceiling Ce��ing
FI•�or �( ,�. Floor
Total Bcu. Total Btu.
Required sq. ft. E.D.R. or eq. ins. W.A. L.eader area / Required sq. ft. E.D.R. or sq. ina.W.A.Leader area
Fl.� Room�L.ength Width t Height �w F�,� Room I L.ength Width eig t
Windows and Doors—Crackage and Area , Windows end Doon—Crackage end Area
Wldth H�IfAt No.ot Lln�al tt. Are• Wldth Hel�hl No.et Lln��l!t. A�a�
No. ot pans of pan• II�At• o[ aek �p.tt. No. o[pane ot p�n� Il�ht� ot erack �0.tt.
r -v
o . �J. .a
1 /
Coef. Btu f. tu
In6ltration In6ltration
Glas� G. Glas�
Eup.wall ` / � ' Exp.wall
Net e:p.wall Net exp.wall
Int.wall Int.wall
('.e�Fnrg •�'�..R �r0 Ceiling
Floor �( 7 Floor
Total Btu. Tota) Btu.
Required sq. ft. E.D.R. or �q. in�.W.A.Leader srea Required sq. ft. E.D.R. or aq. ins.W.A.L.eader area
Fl. � oom Length Width H��gh� � i Fl.� Room I Length Width Height
Windowa and Doon--Crackage and Area Windows and Doon—C�ackage and Area
WIAth HN�ht No.ot Lln�al tt. Area Wldlh Hel�ht No.ot Lln�al tt. Are�
No. ot pan• ot D�ns Il�ht� ot crack �p.!t. No. ot pana ot pan� Il�hu ot craek �q.tt.
�. �
Coef. Btu Coef. Btu
In6ltration Infiltration
Glaii Glass
E�cp.wall ` ' ' " �-s,.._...._ y J Exp.wall
Net e:p.wall � v �, Net exp.wall
Int.wall /?� (,� ,o lnt.wall
Ceiling Ceiling
Floor /�3 ? , Floor
Toeal Btu. � p Toeal Btu.
Required sq. ft. E.D.R. or�q. ins.W.A.Leader are� Required sq. ft. E.D.R. or sQ. ina.WA. Leader area ,
Fl. Room �Length Width Height � Fl.� Room I Length Width Height
Windows and Doon—Crackage and Area Windows and Doon—Crackage and Area
Wldth HN�hI No.ot Lln�al tt. Are� R'Idlh Hsl�ht No.ot Llneal It. Are�
No. ot pan• ot Dan• Iltht� ot arack W•(t. No. ot Dan• ot o�n� Il�ht� ot er�ck q.tt.
Coef. Btu Coef. Btu
In6ltration lnfiltration
Glau Gla�e
Eup.wall ' Exp.w#II '
Net e:p.wall Net e:p.wall
Int.wall Int.wall
Ceiling Ceiling
Floor Floor
Total Btu. Total Btu.
Required sq. ft. E.D.R. or�q. in�.W.A.L.eader area Required sq. ft. E.D.R. or sq. ins. R�A. Leader area