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Home My WebLink About2013-01208 - gas line only RIBRUMNIM CITY OF ORONO * 2 0 1 3 - 0 1 2 0 8 2750 KELLEY PARKWAY DATE ISSUED: 11/13/2013 ORONO, MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 2425 THOROUGHBRED LA PIN : 04-117-23-11-0018 LEGAL DESC OLD CRYSTAL BAY ROAD 2ND ADDN LOT 001 BLOCK 002 PERMIT TYPE MECHANICAL(>$500) PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE GAS LINE ONLY VALUATION $ 450.00 NOTE: GAS LINE FOR STAND BY GENERATOR APPLICANT MECHANICAL 50.00 MECHANICAL AIR SYSTEMS STATE SURCHARGE MECH(VALUATION) 0.23 1473 91ST AVE.NE TOTAL 50.23 BLAINE,MN 55449- PAID WITH CASH 50.23 OWNER DEJUTE,PAUL&SUSAN 2425 THOROUGHBRED 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 isrespons' le for ring all required inspections are requested in confo wit State Building Code.This permit may be revoked at a or due se. / r pl' t Po6nitergnature Date Issued By S' ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. FOR CITY USE ONLY �Ol VO City of Orono P.O.Box 66 Date Received: Permit# 2750 Kelley Parkway Crystal Bay,MN 55323 Approved By: Amount$: Phone(952)249-4600 Fax(952)249-4616 s � � CITY OF ORONO–MECHANICAL PERMIT t�xES H O�� (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL INFORMATION 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. Permit 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 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. 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. TYPE OF PERMIT Check All That Apply) Residential ❑Commercial(Approval Required) ❑New ❑Additional ❑Repairs ❑Replace Job Site/Owner Innfformation: Site Address: G�' T LI G IZoU.� 73tL�Sr Owner: Mailing Address: City: r)12':2 4, Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: �`l5 fig - Contact Person: I 0A ✓�V�L`l�!�l2. Address: j two 6N P1t e 96-State Bond#: City: Zip: Expiration Date: Phone: 7&3— +&+-65-OZ- Alternate Phone: 7�3 ' 4- , ❑ Insurance–Current: 1 MECHANICAL SYSTEMS BEINGINSTALLED Note: All Geothermal Systems will now re uire a Site Plan&Review by our Building Official. IS THIS GEOTHERMAL? ❑ Yes o HEATIISYSTEMS Quantity: ''`` Make: Model: Fuel: Flue Size: Input BTUs: Output BTUs: CFM: COOLING STEMS Quantity: Make: Model: Tons: H.Power FIR LACES ❑ Gas Factory Fireplace Brand Name: ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VE TILATION ❑ No. Kitchen Exhaust duct recirculating cfm ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm 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 pA ❑ Outdoor Grill Ff Other/List What&Where: 2 JV PERMIT FEE CALCULATION(S) BASED OFF-2002 STATE STATUE ❑ 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;excluding 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 Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ PERMIT FEE CALCULATION($)—`.JOBS OVER$500.00 If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) x.0125$ (contract price) (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 permit 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. MECHANICAL PERMIT APPLICATION AGREEMENT 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: Date: 3 /—DATE � TIME CITY FOR NO ED IN .7 _ INSPECTION NOTICE SCHEDULED /!-27 PERMIT NOaU/J-aN w9/ COMPLETED f h ADDRESS —) (/o15 6rUIJ OWNER T E ONEda- CONTRACTOR DESCRIPTION ❑ FOOTING ❑ PLUMBING FINAL EXCAV/GRADING/ IW G 11POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS Cot O ❑ 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 v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: W J �O QC O W Qc Q 2 W RKSATISFACTORY PROCEEDROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OWnerlContrac site: Inspector. White Copyllnspector's File Canary CopylSfte Notice