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Home My WebLink About2010-01052 - gas line only ,� .. CITY OF ORONO PERMIT NO.: 2010-01052 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUEn: 10/26/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 2106 SUGARWOOD DR PIN : 34-118-23-21-0023 LEGAL DESC : SUGAR WOODS : LOT 004 BLOCK 004 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY VALUATION : $ 650.00 NOTE: GASLINE ONLY FOR FIREPLACE APPLICANT MECHANICAL 50.00 AUTOMATIC GARAGE DOOR&FIREPLACE STATE SURCHARGE MECH(VALUATION) 5.00 8900 109TH AVE N SUITE 1000 TOTAL 55.00 CHAMPLIN,MN 55316 (763)571-2525 OWNER SCHOMMER,WCHARD 2106 SUGARWOOD DR 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 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 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 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 t' e for due cause. � .� �—L- /� � ZG �/d /f,� oZLol / Ap icant Permitee Signature Date Is u By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. . � �� z r -- F R �l'X S�,(��TI.� ,�p� City of Orono ��. � � �" � � �„� O P.O.Box 66 Dafe ftece��er�n�t#�� . � � � 2750 Kelley Parkway �� , �:� � � ,�� Crystal Bay,MN 55323 ApprO�ec]�y:''� =Arnount�t ��"�"��. ��o Phone(952)249-4600 Fax(952)249-4616 e CITY OF ORONO—MECHANICAL PERMIT (All Commercial permiu must be approved by the Building Official or Inspector and/or Fire Marshall) ��.�"��t��''�Q� ' �,,:, 1. You may apply for mechanical permits by mail or in person at the City offices. Applicarions will be reviewed and a pernut will be issued within two working days. 2. Pernut 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 Desig�ns—Complete calcularions,details and specificarions are required for each heating,ventilarion,humidificarion-dehumidification,and air conditioning installarion including heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to type,manufacturer and model. Data shall be presented on forxn 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. �`�PE fl�P��II'� ` ` _' .(�he�,.�11'.,'�'�a.t� 1 ,'!: � �Residential ❑ Commercial(Approval Required) � [�New ❑Additional ❑Repairs ❑Replace :��b S�ite 1 Uwx�er hiforrna�on: Site Address: a�� Sv�A�W�� Owner:SvsSrZ �Ro�'�T�T7�� Mailing Address: GSY TXAN.�X�.'D. City: S�-/�`7'?�✓� Zip: �'5�� Home Phone: �s'/- (oS�S=433/ Alternate Phone: Contractor.Tnformation: °';: Contractor: /��i14��TIL Dc�C r+-Fi+�'1°��kE Contact Person: ��r' 1i�e.S�l�i�D Address: �`'l4� /dY��✓r State Bond#: City: C/y''�P��"� Zip: 5��4 Expiration Date: Phone: 763-5 ��' ��aO Alternate Phone: ❑ Insurance—Current: 1 � - \ -- � Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official. IS TffiS GEOTHERMAL? ❑ Yes ❑No HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: Input BTUs: Output BTUs: CFM: � COOLING SYSTEMS Quantity: Make: Model: Tons: H.Power FIREPLACES ❑ 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 Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locarions �� FUEL STORAGE (Must be approved by Fire Marshall if proposing 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: f/RFPL�1'LC 2 . . s, . - ❑ Yes,this section applies The replacement of a Residential fixture or appliance that rneets all three of the following requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less; 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 Pernut $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ If above does not apply; follow guidelines below: 1. CONTRACT PRICE *is 1.25%of coniract price with a(Minimum Fee of$50.00) �� .0125$ ,�� (contract price) (minimum$50.00) 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$5.00) x.0005 $ �� (contract price) (minimum$5.00) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �7�� ■ * 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 installarions 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 pernut 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 times the Contract Price or a minimuxn of$5.00. 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: ��%a'�' Date: %._2��D 3 �_� a TIME v C'�i� �T / CITY OF ORONO CALLED IN �� 6��!`� INSPECTION N TICE CHEDULED � � � �b PERMITNO. �� ED ADDRESS �`� ��- OWNER EL ONE O. 7 - �� CONTRACTOR � , �: DESCRIPTION � � ❑ FOOTING PLUM IN INAL ❑ EXCAV/GRADI ING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL p TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP � ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAI � OWNERICONTRACTOR TO MEET YOU:_YES_NO v�, COMMENTS: � W C � �C�� -�- 5 � 0 � �]��,c, �� n S v � A -��"v� 0 � W � Q � Z W � W � � � o`��. KSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REIPISPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cali for the next inspection 2a hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector. �1 White Copyllnspector's File Canary CopylSite Notice