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Home My WebLink About2015-01300 - gas line only � � CITY OF ORONO * Z 0 1 5 — 0 1 3 0 0 * ' 2750 KELLEY PARKWAY DATE ISSUED: 10/07/2015 ORONO,MN 55356- 952 249-4600 FAX: 952 249-4616 ADD SS : 3050 SUSSEX RD PIN : 04-117-23-32-0010 LEG �D C : FOX BEND : LOT 004 BLOCK 001 PER �T PE : MECHANICAL(>$500) PR �R TYPE : RESIDENTIAL CO S'I'R TION TYPE : GAS LINE ONLY VA II�AT N : $ 1,000.00 NO :; G LINE TO GENERATOR THROUGH SOFFITS APPLICANT MECHANICAL 50.00 STATE SURCHARGE MECH(VALUATION) 0.50 P �CT AL SYSTEMS MAIL-IN FEE 2.00 4 4�B DY OAK RD �K S,MN 55343 TOTAL 52.50 ( 52)9 1868 Payment(s) CREDIT CARD 3543 52.50 OWNER AKER,RONALD&SUSAN 0�0 SSEX RD C1N AKE,MN 55356- � EMENT AND SWORN STATEMENT GRE hall be erformed accordin to 'f�e w k for which this permit is issued s p g tl�e ap oved plans and specifications,applicable City approvals,and the State ilding Code. This pertnit is for only the work described and dces npt g t permission for additional or related work which requires separate qermi All provisions of laws and ordinances governing this rype of work s�all compied with whether or not specified herein.This permit will e�xpir d become null and void if construction authorized is not �om nced within 180 days of the date of issuance,or if construction is �us ed for a period of I80 days at any time after work has commenced. he licant is responsible for assuring all required inspections are tequ ed in conformance with the State Building Code.This permit may be �evo at any time for due cause. � � /v � 7 ,�.� iAp cant Permitee Si ture Date Is ued y Signature Date I 9 91331 9 15:24:39 10 07-2015, 2/4 * ,� FOR C--�USE ONLY City of Orono /Q �O�O P.O.Box 66 Da�e Receivcd: 7 Permit# ��`f �� 2750 Kclicy Purkway Crys[al Bay,MN 55323 Approvcd By: Amount�: Phone(952)249-4G00 Pax(952)249-4G1G ' y � ��qk�SH��,G` CITY OF ORONO—MECHANICAL PERMIT (All Commcrcial permits must be approvcd by thc Building Official or Fnspcctor and/or Firc Marshatp I GENERAL INFORMATION I. You n�ay apply for mechanical permits by mail or in person at the City offcces. Applications will be reviewed and a permit will be issued within hvo�vorking days. 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MIJST NOT BEGIN UNTIL THE PERMIT CARD IS POST�D ON THE JOB SITE. � 3. Mechanical Desiens—Complete calculations,details and specifications are required for each l�eating,ventilation,humidification-dehumidification,and air conditioning insEallation 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. 4. When any ne�v construction or remodeiing is involved,a separate building perrnit must be obtained. 5. All work must be done in accorda�ice with the Unifonn Mechanica!Code/State Building Code requirements. 6. All�vork must be inspected(rough-in and final). Call(952)249-4600. (2448 hour notice required) 7. House Heating Test Record must be sub�nitted before final. � TYPE OF PERMIT (Check All That A 1 ) �Residentiaf ❑Commercial(Approval Required) ❑ New ❑Additiox�al ❑Repairs ❑Replace Job Site/Owner Information: �— <, _:s ��C� I Site Address: `�� Jl�.,� ,'��j�..� � Owner: ��1C(1 �jC��`t1 �:�'Z..1°��'� Mailing Address: �.i�� J�E;:�:�`�`�� . � City_ �,.001C:.� �.C.3�.:�`�Le---- Zip: �c�?j�� Home Phone: �.��i�}' ��" (��v�1 Alternate Phone: Contractor Infoxrnation: ,' , , , � � LI Contractor: �i_-�t SiCC-{� .� �..�5`��1'Y�.:�ontactPerson: �_..G��C� �.�C�S_/C-Ef��-��_ h Address: �I�la� �7 �Y;�C;..�.�� ➢,.k.. ��- State Bond#: �-��.Cf�C...��1 `�,, i City: �� , F L._=� Zip:��"?jExpiration Date: C{" ' �� ' j(� Phone: �G��- �I t��y�) - ��n0 Alternate Phone: ❑ Insurance—Current: i..-I<`"�� 1 � , _ __ I I 9 g331 9 15:24:57 10-07-2015 3!4 * i� MEGHANICAL SYSTEIvTS BETNG INSTALLED I Note:AlI Geothermal Systems will now require a Site Plan&Review by our Building Official. I IS THIS GEOTHERMAL? ❑Yes,�'No HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: I 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/Masonry VENTILATION No. Kitchen Exhausi duct recirculatin� cfm ❑ b ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locatio�s cfm FUEL STORAGE (�tilust be upproved by Fire Marslrall if proposnrg to abai:do►r ta�rk in pluce.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside � LP Gas: gallons Other: • ._.r'�M., ;... GAS LINE ONLY �Gi`� (��)L. �Z� ��.._) K'_�C�l:K Y� ' ❑ Outdoor Grill � Other/List What&Where: f I f -�z� ~L��"�z.ti-c:�.fiU� . I 2 I � � i 9529331869 15:25:09 10-07-2015 4!4 �I�' # PERMIT FEE CALGULATION(S) I BASED OFF-2002 STATE STATUE � I ❑ Yes,this section applies The repiacement of a Residential fixture or appliance that meets all three of the following rec�i�irements: l. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less;excIuding the cost of the fixture or appliance: and 3. Is improved,installed or replaced by the homeowner or ticensed contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ 1 AO Mail-In Fee(Tf Applicable) $ 2.00 I�i Total Permit Fee $ I PERMIT FEE CALCULATTON S)-:JUBS OVER$500:00 � If above does not apply;follow guidelines below: I. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) -� �ccr .c:� X.0�25$ � ��:� . t� (coi»ract pricc) (minimum$50.00) 2. STATE SURCHARGE ,� (C� �j x.OQOS � , � (contract pricc) 3. POSTAGE&HANDLING(Only on Mail-In Applications) � .� 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ��} �`�� ■ * CONTRACT PRICE or ]OB COST means the actual or estimated dollar amount charged for the permitted work including materials, labor,proft,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 o�vner, 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 event that there is a dispuke on the amount of the job cost, the City may request the submission of a si�ned copy of the actual contract. ' NIECHANICAL;PER1vIIT APPLICATION AGREEMENT � _ _ The undersigned hereby applics to the City for issuance of a Mechanical Pern�it, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the Statc of Minnesota, and certifes that all statements made on this application are complete, true and correct. � / . � C_./ �' ��I�,/t A plicant's Signat re: '�G/YL(.�. �� L��'-�..x-t%��. Date: ��/� �� P / , ;I 3 _ �, _ / LC�� TIME DATE CITY OF ORONO CALLED IN � � INSPECTION NOTICE SCHEDULED PERMIT NO.�j�� COMPLETED ADDRESS '�� cS1 a SSe� � OWNER TELEPHONE NO.�S��3�I g� CONTRACTOR �1�(� � St �Sr� � DESCRIPTION , 4~j ❑ FOOTING ❑ DEMO-FI AL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHA ❑ SITE INSPECTION Q ❑ FRAMING M ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ E TIC INSTALL 2 OWNERlCONTRACTOR TO MEET YOU: YES_NO � COMMENTS: . _ � � � Go.�o�✓ �.� �..ce -�ior.�. �,,r�L�� •� 7� j ' . o w�e��• r�.�. - a.-- ��t �s' �•�,-� � i �' </ �o��5 s. s s.��@,, Set��e.0� � ° _ S�s/ 4 a p�•�e6,4c�..� o.�. �,.�..�,.... � — 5t�a� �4h,-•�r. � •'�^rc•-�4••�, c l.sy-a-ress Q �. 2 ' �G51C ��. �i 7'b 5 t�.s rs�s .� � W �C , O . W O WORKSATISFACTORY:PROCEED ❑PROJECT COMPLETE � ,' CORRECT WORK 8 PROCEED O ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT _ ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR W{LL REfURN O STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Mr the next ins ion 24 hours in advance. (952) 249-46�� Own ontract . �?s � �^• Inspect . /""" White Copyhnspector's File Cenary CopylSite Notke � � `�JX� _ \ / CITY OF ORONO CALLED IN ��DATF,�_ TIME V d� INSPECTION NQ�� J�I�/9�1 SCHEDULED d-�� PERMIT NO. �� J ��n co�epL�reS ADDRESS �J � OWNER TE PH E NO. �--� d3Z' CONTRACTOR �a- � DESCRIPTION 4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YiOU:_YES_NO c�.� COMMENTS: � W � � OO ,� � OO ' W R Q � W ✓ - � W � J W ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE � �CORRECT W'ORK d�PROCEED ❑ UE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECONERING PERMANENT �CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 rs in a . 9 2) 249-46�� OwnerlContractor on site: Inspector: � ' ' WhiM Copyllnspectw's Flle ,.� Gnary Copy e Notice