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Home My WebLink About2011-00380 - gas line only � .� CITY OF ORONO PERMIT NO.: 2011-00380 � 2750 KELLEY PARKWAY ORONO,MN 55356- DATE IssuEn: OS/23/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 395 SUSSEX LA PIN : 04-117-23-24-0007 LEGAL DESC : FOX BEND : LOT 006 BLOCK 001 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL ' CONSTRUCTION TYPE : GAS LINE ONLY ; VALUATION : $ 1,000.00 NOTE: GAS LINE TO OUTDOOR BBQ � APPLICANT MECHANICAL 50.00 GRABOW PLUMBING,INC. STATE SURCHARGE MECH(VALUATION) 0.50 8420 REDWOOD STREET COON RAPIDS,MN 55433 TOTAL 50.50 �) Minnesota State License#: 038623PM OWNER CAMPBELL,JON&SUSAN 395 SUSSEX LA 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 governing 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 are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. d��Gc/��-�- r— � l � l << l l Applicant Permitee Signature Date Issued By Si ture ate SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABO E. ..� :., � ' . � CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT ` Box 66 (2750 Kelley Parkway) �" � ; Crystal Bay, MN 55323 "�� n� ;:� GENERAL INFORMATION � ?� 1. You may apply for mechanical pernuts by mail or in person at the City offices. Applicarions 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 I�OT VALID UNTIL YOU RECEIVE A PERMIT. WORK I�fUST NOT BEGIN t�1TIL THE PER�iIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desi�ns -Complete calculations, details and specifications are required for each heating, ventilation,humidification-dehumidification, and air conditioning installation includino 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 in��olved, a separate building permit must be obtained. 5. All work must be done in accordance with the Uniform Mechanical Code/State Buildins Code requirements. � 6. All work must be inspected(rough-in and final). Call (952)249-4600. 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. Si� and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call (952) 249-4600. Please check one: ❑ New ❑ Addition �Repair ❑ Replace [�Residential ❑ Commercial �� ; JOB SITE: 39� �.ss� �•�. Zip: �S3s6 Owner's Name: �Q,,,,o,6�i/ ,r�. Phone Number: Mailing Address: sa�,f City: Zip: Contractor's Name: �rG 6 e�,, r%� �-,Tc Phone Number: _ ��- 9£�6 •3sf� Mailing Address: �y,�o �pu/r,.,�,�� .� City: �o-, ,��,�,f Zip: �y,� " � f si , — _'. �:� .,:..i�. � .�` .; . � � ,��'s. �.,�.: r��A 1 'e4 .3 . . ' . . � . ... . . - . -� . . .. . . . . .. ' . . 4l I , � � r . ;-s PERiVIIT FEE CALCULATIO\(S) " 2002 State Statute ❑ Yes This Section Applies The replacement of a Residential fixture or appliance that meets 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; excludinQ the cost of the fixture or appliance: ` and 3) Is improved, installed or replaced by the homeowner or licensed contractor. - Skip next section; Cost of Permit $ 15.00 State Surcharge $ .50 Mail-In Fee $ 1.50 If above does not apply, follow guidelines below: 1. Contract Price* is .0125%of job�ith a Minimum Fee of($35.00) � i000 x .0125 $ (contract price) (minimum$35.00) 2. State Surcharge. ** Add the State Building Code Division a Minimum Fee of($ .50) x .000� $ (connact price) (minimum$.50) 3. Postage and Handling (Only mail-in applications) $ 1.50 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ *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 is fumished 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 permit fee purposes. In the e�ent 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-v��hichever is greater.For valuations over $1,000,000 call the Department of Inspectional Services for the price. T'he undersigned hereby applies to the City for i-�cuance 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: �d�� Date:-�� ' Approved By: Date: 3 � { �4 � SYSTEM DESCRIPTION - HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: . Input BT`Us: Output BTUs: CFM: � - COOLING SYSTEMS Quantity: Make: Model: Tons: H.Power FIREPLACES GAS LI\� ONLY ❑ Gas factory fireplace ['Installing a Gas Line Only ❑ Wood burning factory fireplace with fl�e 74 ��n� �e� ea ❑ Wood Stove ❑ Wood stove with flue Brand Name Model No. VENTILATION No. Kitchen Exhaust duct recalculating cfm No. Bath Exhaust (must have duct oLside) cfin No. Other Fans: Locations cfm FUEL STORAGE (MUST BE APPROVED B�'FIRE MARSHAL) ❑ Installation or ❑ Removal � ❑ Fuel oil: gallons ❑ undergrour_d ❑ inside ❑outside ❑ LP Gas: gallons ❑ Other Cras opening � � D T TIME � CITY OF ORONO CALLED IN ✓�'� INSPECTION OTICE 2 SCHEDULED ' - �� PERMIT NO. � �✓�� COMPLEfED /' n ADDRESS 3�CJ �►'��-o'y""f- OWNER TELEPHONE N0.7�3 7��0 �� CONTRACTOR �r D l�t� � DESCRIPTION ua'� — - " ~'� ��"� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS 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 v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO c�.� COMMENTS: � W a � J O � � O � W � Q � Z W � W � � O I�WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W�❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,GALL FOR REINSPECTION TEMPORARY V BEFOREC�IERING PERMANENT ❑CORRECTUNSAFECANDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-46�0 Owner►Con site: Inspect White Copyllnspector's Flle Canary CopylSfte Notice