HomeMy WebLinkAbout1992-004787 - mechanical PERMIT
' CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 MEC•HAN I C•AL
Permit Number: CSC x4717
Crystal Bay, Minnesota 55323 Date Issued:
1= '�
(612) 473-7357 f
SITE ADDRESS:
4750 NiRTH SHORE OR
_6
P. I . N. = 07-117-23-322-0010
DESCRIPTION:
1 HEATING SYSTEMS CFM 1 ,200 FLUE SIZE 2 1/2
FUEL ,, NATURAL GA's MAKE CARRIER
MODEL 68 XC(:18t-jc i_'fftTPUT 2,OOC
INPUT 8 000
1 GA's LINE INSPECT
CITY OF ORON0
FIMWE OFFICE
1313344044 #
221
41 [I 3 .04
REMARKS: 01 GEN .54
CHECK IL 3tU&17
50
RECEIPT-Tt�#+�K Y0441 R01
FEE SUMMARY:
Ease Fee $30.00
Surcharge ----------I_5t
Total Fee $30 .50
CONTRACTOR: - Applicant - OWNER:
COUNTRYSIDE HTG ?t COOLING 34451299 THOM'=ON J I M
10880 CTY RD 20 4750 NORTH SHORE DR
DELANO MN S5328 MOUND MN 55364
(612) 446-1299 9 472-1867
THE t-iNI-ERS I GNEO HEREBY REQUESTS STS PERri I ` IFN TO tIAK.E THE REAL I t##=`R iVENE t '"f
IFIEf ANC? AGREES Ti_' DI.-I LI L f�;t_Ri-r: IN TRIC T 0:�MM I�:M E 'KITH A .L C: Ty: IJ
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;:I�,�=�r>O I IRDINANCr S N41 STATE ;_I,` MIS 1s E ' 0TA. i-UILDING � I I7C= R •= 1 t��r��-r�#T'=:
i
C NT/PERMITEE SIGN E ISSUED BY:SIGNATUME
a.
CITY OF ORONO
APPLICATION FOR MECHANICAL PERMIT
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City
offices. Mailed-in permits are subject to the postage and handling fees
shown below.
2 . Permit cards will be sent by return mail the same day the application :is
received. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST Nt_ T
BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE.
3 . When any new construction or remodeling is involved, a separate building
permit must be obtained.
4 . All work must be done in accordance with State Building Code requirements.
5 . All work must be inspected (rough-in and final). Call 473-7357. 24-hour
notice required.
6 . House Heating Test Record must be submitted before final.
INSTRUCTIONS Complete all items on this application. Compute the permit fee.
Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.
If you have questions, call 473-7357.
WALK-IN PERMITS apply at City Offices, 1335 South Brown Road (Cty. Rd 146)
MAIL-IN PERMITS enclose fee - Mail to: P.O. Box 66 , Crystal Bay, MN 55323
Please check one: New Addition Repair ✓ Replace
JOB SITE: 117. _J l Lrt� �_ho rG P r Zip: -5-S-3(, /
Owner' s Name: J_i yo -7f,0 V,„s h,- Telephone Number:
Mailing Address : C,, Y-1- City: Y_�6 VVZip: 5 6LE
Contractor' s Name: CoLAvwfr4Q' L )A -g -+- LL-c Telephone Number: 446-121<3
Mailing Address ��� go Co 2� 7r�`T_ City: De_L(D L 0 Zip: 553zf
********************************************************************************
MINIMUM FEE ( $30. 00 per project)
********************************************************************************
SYSTEM DESCRIPTION: $15 . 00 each unit
Heating Systems :
Quantity: 1
Make: Cs r.F
Model: ��x-c-o Cs
Fuel: Ncd
Flue Size: ZYz" PV/_ n�
Input BTUs : ,�ba
Output BTUs : �z,o6
CFM: rZ ob
********************************************************************************
Cooling Systems :
Quantity:
Make:
Model:
Tons:
H.Power:
.. .. ..... .. .. ..
+1
*WOOD BURNING EQUIPMENT $15.00 each unit
Wood stove with flue _..
Wood combination or add-on unit
Factory fireplace with flue
Factor Fireplace (s) freestanding Masonry .
Wood Stove (s ) franklin, other
BrandName Model No.
Mfgr' s Min. , Clearances, side , rear , min. flue dia.
Total
********************************************************************************
VENTILATION $15. 00 each project
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside ) cfm
No. Other Fans : Locations cfm
Total
********************************************************************************
FUEL STORAGE (must be approved by fire marshal )
$30 . 00 Permanent/Temporary
Fuel oil, gallons underground inside outside
LP Gas, gallons
Other Gas opening
********************************************************************************
GAS LINE INSPECTION
High/Low Pressure $15 . 00
PERMIT FEE CALCULATION
1. Total of above Installations or Minimum Fee ($30.00) $
2 . State Surcharge. Add the State Building Code Division
Surcharge to each permit $ . 50
3 . Postage and Handling on all mailed-in applications , $ 1 . 50
4 . TOTAL PERMIT FEE add lines 1-3 above $
The undersigned hereby applies to the City of issuance of a Mechanical Permit,
acrees 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: -j�— ���`7( Date: i �- 1Z- �t '2�