HomeMy WebLinkAbout1990-003417 - natural gas heating system PERMIT
CITY OF ORONO PERMIT TYPE:
417
11/09/90
1 417
1335 Brown Rd. South • P.O. Box 66 Permit Number: c,03HAN 417
Crystal
CAL
Crystal Bay, Minnesota 55323 Date Issued:
(612) 473-7357 1 f�s_=�Ic}
SITE ADDRESS:
1:35S VINE PL
LSV
P. I . N. : 07-117-231–Cat:,_,-
DESCRIPTION:
1 HEATING SY:OTEM FLUE SIZE 6 FUEL NATURAL GAL*
MAKE LENNOX MODEL G20Q3/4E-100
INPUT 100,0 is
REMARKS:
FEE SUMMARY:
Base Fee $30.00 MAIL IN ----------*
Surcharge ------_– –I-5Q Total Fee $32.00
Subtotal $30.50
i
CONTRACTOR: -- Applicant -- OWNER:
S3EDGW I CK HTG 6 AC CO 38819 700 VENTRES DANIEL
i
8910 WENTWORTH AVE S 1365 VINE PL
MINNEAPOLIS MN 55420-2314 ORONO MN SS364
(G 12) 881-9000 (S12)472-2063
THE r NI-)ERS-I GNEG HEREBY F,E-QiJkE'STS F'F.:��;�1 I SS I ON TO_ TH- REr,L i t°iPRF-1VE NEN'Tt:-;
S ;F'Ei:I FF�I ED AND AGF�EE lrfi DO ALL WORI I N 'S'TRICT CO F1 I ANC:E ��1 1 i 1 ALL %:I T''
13RONO ORDINANCES AND i TATE MINNESOTA SUILDINLS Ci ID RE
APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO 2 �PONo
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 ad handling fees
shown below. Wov
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 NOT
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
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Please check one: New Addition Repair Replace
JOB SITE: 5 Zip:
Owner' s Name: Telephone Number:
:.aiy�:-:g Address : a r �� Cit Zig:
Contractor ' s Name: Telephone Number: � J-StrlrZ�
Mailing Addressb ;c�V,-ninyor�THAVF_so_ City: Zip:
MINIMUM FEE ( $30. 00 per proje�t)
********************************************************************************
SYSTEM DESCRIPTION: $15 . 00 each unit
Heating Systems :
Quantity:
Make : j
Model .
Fuel.
Flue Size : (�
Input BTUs : /LIZ) ,Pr
Output BTUs :
CFM:
Cooling Systems :
Quantity:
Make:
Model:
Tons.
H.Power:
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*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
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VENTILATION $15 . 00 each project
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside ) cfm
No. Other Fans: Locationscfm
Total
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FUEL STORAGE (must be approved by fire marshal )
$30 . 00 Permanent/Temporary
Fuel oil, gallons underground inside outside
LP Gas , gallons
Other Gas opening
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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 $ ;,1 ._
The undersigned hereby applies to the City of issuance of a Mechanical Permit,
agrees 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: Date: ;r- ,..:
.7rLeA_',
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB NO. D 7
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 (612) 881-9000 TEST RECORD
ADDRESS �J / CITY Of oil 0
OCCUPANT�TI��' AM0/h II P-M f eS OWNER �(
SOLD BY S ej G[.y I'C- INSTALLED BY SC G►W I G P
MAKE ��Vlp�l MODEL
SERIAL NO. �O/d K.OO O INPUT /00 9 600 h ! U
v
THERMOSTAT �O � VENT SIZE
VALVETYPE OF LINER
LIMIT CON LINER SIZE ^--�-
LIMIT SETTING '`� FILTERS: SIZE EICC�foi l'C NUMBER
FAN SETTING �l�l I WIRING
PILOT TYPE TEST TAG
IGNITION MODEL LIGHTING INST. Q
PILOT TIMING T11 SLiA
a DATE TESTED 12- ZI �/ d
PRESSURE �'1W�L� PERCENT CO2
loo PERCENT 02 O O COMPANY TESTING
INPUT CFH
STACK TEMP. 3,��,�_ PERCENT CO A/0 NAME OF TESTER ,
FORM 235(REV.11/89) FORM DISTRIB ION: WHITE COPY-JOB FILE YELLOW COPY-CITY