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Home My WebLink About2012-00058 - gas line only ' - CITY OF ORONO PERMIT NO.: 20�2-000ss 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: OU27/2012 952 249-4600 FAX: 952 249-4616 ADDRESS : 3190 SUSSEX RD PIN : 04-117-23-32-0007 LEGAL D SC : FOX BEND : LOT 001 BLOCK 001 PERMIT PE : MECHANICAL(<$500) PROPERT TYPE : RESIDENTIAL CONSTR TION TYPE : GAS LINE ONLY NOTE: GA LINE FOR STOVE AND DRYER APPLICANT MECHANICAL(<$500) 15.00 NYBO-PE RSON CO.INC. STATE SURCHARGE MECH(<$500) 5.00 6606 280T . STREET TOTAL 20.00 MN 5508& (952)461-2 49 PAID WITH CC# 2234 Minnesota ate License#:058650 OWNER KENNEY, OHN&MARY 3190 SUSS X RD LONG LA E,MN 55356- AGR EMENT AND SWORN STATEMENT The work for hich this permit is issued shall be performed according to the approved lans and specifications,applicable City approvals,and the State Buildin Code. This permit is for only the work described and dces not grant pe ission for additional or related work which requires sepazate permits. AII p ovisions of laws and ordinances goveming this type of work shall be comp d with whether or not specified herein.This permit will expire and be me null and void if construction authorized is not commenced thin 180 days of the date of issuance,or if construction is suspended for period of 180 days at any time after work has commenced. The applicant s responsible for assuring all required inspections are requested in c nformance with the State Building Code.This permit may be revoked at an time for due cause. � � � ,a� ,l a— A 'can P i ature Date Issued y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � • �• F - �t TJSE"�;1�1�.Y � l�� City of Orono "' � � £ � ��"�'� P.O.Box 66 Date'�ecet Per►�t-# ��+�� 2750 Kelley Parkway �� ' `�� ' Crystal Bay,MN 55323 Apprqved$y : A�mia�rtt'� �� L_ �� Phone(952)249-4600 Fax(952)249-4616 �wa� CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) G��xa1.�o�Tia�v 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. Perxnit 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 Desi¢ns—Complete calculations,details and specifications are required for each heating,ventilation,humidification-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 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. T�i'.�'E,x�1F PEI�T= ,: ��l�ec`k�:�hat:� 1`'), �. �Residential ❑ Commercial(Approval Required) ❑ New �[]Additional ❑ Repairs ❑Replace '�ob'��8 I`��vner`�rif�T�ua.�t�ri°` '' Site Address: �1�� S e.- � s - Owner: K c? il/il/-G (.� Mailing Address: l City: ��,�/(� Zip: Home Phone: �fa�- �� d'� Alternate Phone: 3Coi�`tiactor'�ci�na.t�cin: Contractor;��/��, !/l.e 7��'a,v Contact Person: C l� /1�� Address: ��G� ��5��C S� State Bond#: City: a- Zip�g Expiration Date: Phone: �� o�� lq/� Alternate Phone: ❑ Insurance—Current: 1 a � Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. � IS THIS GEOTHERMAL? ❑ Yes ❑No HEATING SYSTEMS Quanrity: 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/Masonry VENTILATION ❑ No. Kitchen Etchaust duct recirculating cfm ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FLTEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in plac�) ❑ Installarion ❑ Removal Fuel Oil: gallons ❑ Underground ❑Inside ❑ Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List What&Where:�)�C�`�� (,�� '—� 2 � - ❑ Yes,this secrion 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;excludin�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 contract price with a(Minimum Fee of$50.00) / f�� x.0125$ (contract pnce) (minimum$50.00) 2. STATE SURCHARGE x.0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 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 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 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 undersigned hereby applies to the City for issuance of a Mechanical Pernut, 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: ' � � Date: (`—a �"— �� 3 �� S � jl DAT � TIME � li�� CITY OF ORONO —�eAtt�iN INSPECTION NOTICE HEou�E� � PERMIT N0. -' MP�ETED ADDRESS �3� `/�- ��1��4L�� OWNER T LEPHONE NO. �`� CONTRACTOR ' DESCRIPTION N � ❑ FOOTING ��L NG FINAL ❑ EXCAV/GRADING/FILLING ❑ POURED WALL ❑ ME ANICAL FI ❑ LAKESHORE/WETLANDS ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION ❑ RADON SLAB O WATER HOOK-UP ❑ PROGRESS ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL TALL ❑ HARD COVER REMOVAL J ❑ P G RI ❑ SEPTIC FINAL OUNDATION/REMOVAL � NER/CONTRACTOR TO MEET YOU:_YES_NO CO NTS: � - �� -booSS —� � _ 5� c 0 � � 0 � Q /� 1C� c� . � � �-�.� �� --�:,' /ls� �- � z w � W � � GW�K SATISFACTORY:PROCEED [_l PROJECT COMPLETE � ❑CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR W4LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: Inspector. �`/ - �.. � White Copyllnspector's File Canary CopylSite Notice