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HomeMy WebLinkAbout2013-01083 - mechanical CITY OF ORONO * 2013 - 01083 * • 2750 KELLEY PARKWAY DATE ISSUED: 10/16/2013 ORONO, MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS 4755 TONKAVIEW LA PIN : 07-117-23-32-0057 LEGAL DESC BERGQUIST&WICKLUNDS PARK LOT 000 BLOCK 002 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE HEATING SYSTEMS VALUATION $ 2,500.00 NOTE: 1 TRANE NAT GAS FURNACE APPLICANT MECHANICAL 50.00 TOTAL COMFORT 4000 WINNETKA AVE N STATE SURCHARGE MECH(VALUATION) 1.25 SUITE 10 MAIL-IN FEE 2.00 NEW HOPE,MN 55427- TOTAL 53.25 () OWNER MARONDE,KIM G&HONI L 4755 TONKAVIEW LA MOUND,MN 55364- 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. a , Applicant PeHitee Signature Date Issued FU Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBE BOVE. City of Orono FOR CITY USE ONLY Q O�O T► P.O.Box 66 Date Received: Permit# 2750 Kelley Parkway Crystal Bay,MN 55323 Approved By: Amount$: Phone(952)249-4600 Fax(952)249-4616 CITY OF ORONO–MECHANICAL PERMIT kf S H O� (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL INFORMATION 1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Designs—Complete calculations,details and specifications are required for each heating,ventilation,humidification-dehumidification,and air conditioning installation including heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to type,manufacturer and model. Data shall be presented on form provided. 4. When any new construction or remodeling is involved,a separate building permit must be obtained. 5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code requirements. 6. All work must be inspected(rough-in and final). Call(952)2494600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before final. TYPE OF PERMIT Check All That Apply) Residential ❑Commercial(Approval Required) ❑New ❑Additional ❑Repairs ❑Replace Job Site/Owner Information: Site Address: y -1 5 5 Tzn ay l tto rN I Owner: ' W t< ��lo C(Y1.1Z40 Mailing Address: � to D d c7'-hob cl City: �� /QEQrlc) Zip: MovuA'`nv-) 5s3(0 `{ Home Phone: -��$OU�t Alternate Phone: a Contractor Information: Contractor: [4' Contact Person: Address: L�OCX,-'*� W i/IA-U§tate Bond 9: — City: Zip Expiration Date: Phone: �03. � Alternate Phone: Insurance–Current: 6�c 1 Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official. IS THIS GEOTHERMAL? ❑Yes J&o HEATING SYSTEMS Quantity: Make: Model: �-XD ' oQA9 Fuel: Flue Size: Input BTUs: co Output BTUs: l7 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 Exhaust duct recirculating cfin 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 ❑ Outdoor Grill ❑ Other/List What&Where: 2 ❑ Yes,this section applies The replacement of a Residential fixture or 4pnliance 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 $ t 3Al :xA r If above does not apply;follow guidelines below: P 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) c 15on .00 x.0125$ 0,�d � (contract price) (minimum$50.00) 2. STATE SURCHARGE 11bO,S �( , x.0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2..00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ _S` ,a S ■ * 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. t* 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 Signa Date: 3 ACORU® CERTIFICATE OF LIABILITY INSURANCE DAT2013 D/YYYY) 10/92013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: JennaAnderson Marsh&McLennan Agency LLC PHONAX,tE Exti:7 - 4 - Fax 8000 No - - 8684 7225 Northland Dr N#300E-MAIL Minneapolis MN 55428 ADDREss:an n' r' n INSURERS AFFORDING COVERAGE NAIC S INSURER A:The Builders Group INSURED TOTACOM INSURER B:TeChnology InsuranceCompany A-ABC Appliance&Heating Inc INSURER C:EM InSurance Companies dba Total Comfort 4000 Winnetka Avenue North INSURER D: New Hope MN 55427 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:123026688 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSCY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM DDS MMIDONYYYY LIMITS C GENERAL LIABILITY 41393230 /1/2013 11/2014 EACH OCCURRENCE $1,000,000 XCOMMERCIAL GENERAL LIABILITY DAMAGEPREMISESS( RENTED Ea occurrence) $300,000 CLAIMS-MADE K OCCUR MED EXP(Anyone person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY X PRO-E_T LOC I PD Deductible $1,000 C AUTOMOBILE LIABILITY 4E93230 112013 /1/2014 Ea accident $1 000 000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ 1AUTOS Per accklent C UMBRELLA LIAS X OCCUR 4J93230 11/2013 11/2014 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED x I RETENTION$10,000 $ A WORKERS COMPENSATION 020001644-MN ONLY /1/2013 /1/2014 X WCSTATU- I OTH- B AND EMPLOYERS'LIABILITY YIN TARKS48778-KS Only 10r2312012 0/23/2013 TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,AddKlonal Remarks Schedule,0 more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Orono ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 66 2750 Kelley Parkway AUTHOR DREPRESENTATIVE Crystal Bay MN 55323 ©1988-2010 ACORDG CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD kv DATE QS,,jIME V CITY OF ORONO CALLED IN INSPECTION,NpIIE O � �� SCHEDULED U PERMIT NO.�� COMPLETED ADDRESS q_7 "6'1kc0-VQ 10-r*--t OWNER 1 Cs c-aa TELEPHONE NO. `_,�l _WV 2.605 CONTRACTOR T6t&-(GrY74�yi n�LIQ.Fc� DESCRIPTION RifeC=CR ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q EJ POURED WALL PACALAL__ ❑ LAKESHORE/WETLANDS H ❑ FRAMING ❑ MECHANICA ❑ TREE REMOVAL Z ❑ INSULATION EPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO cam., COMMENTS: W a J O O W cc Q 2 W Z W 2 j O Wcc ❑WORK SATISFACTORY:PROCEED OCE�OJECT COMPLETE W ❑CORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. White Copy/Inspector's File Canary Copy/Site Notice