HomeMy WebLinkAbout2009-00127 - gas line only CITY OF ORONO PERMIT NO.: 2009-00127
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 03/30/2009
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4545 WATERTOWN RD
PIN : 31-118-23-24-0004
LEGAL DESC : UNPLATTED 31 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : GAS LINE ONLY
VALUATION : $ 500.00
NOTE:
GASLINE ONLY TO NEW FIREPLACE
APPLICANT MECHANICAL 50.00
CENTRAIRE HEATING&AIR STATE SURCHARGE MECH(VALUATION) 0.50
7402 WASHINGTON AVE
EDEN PRAIRIE,MN 55344 TOTAL 50.50
(612)941-1044 PAID WITH CC# 5794
Minnesota State License#: 00TR93
OWNER
BROLL,MR&MRS JEFF
4545 WATERTOWN RD
MAPLE PLAIN, MN 55359
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 i ,onsible for assuring all required inspections are
requested i onf• a. •wit e State Building Code.This permit may be
revoked; ime '• e ause.
t/ / / 3/ 30 �� o o
App icant Permite Signat e Date Is /PIA a � / te 1
Issue d By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Nov-03-2000 0930am From-CITY OF ORONO +9522494616 r-024 P.ucuuua i•-;ii)ki
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. City of Orono
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2750 Kelley Paltway
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,44r.L1> Crystal Bay,MN 55323
(952)249.4600 ,Allstro BY ATIP --....
CITY OF ORONO-MECHANICAL PERMIT
(Ail Comrucrcial permits must be approved by the Building Official or Inspecior a4/or Fire Iviarshall)
ITGE .E.ItArNitiiiMATION H : •.' ::: .. : .:. .H . ,:.'' ;.:!' :, I.!
I. 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 POSTEDQIiTittJ .1 19: TE,
3. Mechanical Designs—Coraplee calculations,details and specifications are required for each
hearing,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 buikhng permit must be
obtained.
5. All work must be clone in aceordarice 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.
. . . . ----, , .
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. -:. : . : ' .• : . :: . • cCh.cliti,t4 1 . Li_;.L.___IL_,,,i_ _
pKItesidential El Commercial(Approval Required)
Ej New ID Additional n Repairs 0 Replace
. .
I Job /Owner 4fOrglatiedl:
Site Address: 115. 15LiAtirjikft2A.J4VIL_
Owner: ( Mailing Address: 4,.... ,_1(Z__,_jideiWt
City: CDP1440 Zip: .S-53S-b
Home Phone: _ Alternate Phone: -
Contractor fnjfonnatio*
Contractor: Getbyive II 44A-r1-46-Contact Person: tkiielfr-fre
Address: 92 '
State Bond 4:
7IPokyitfithe ffi-,1'C73R)2.
City: £ L13U4 Zip:,6WExpiration Date:
Phone: Oft AA
te" e ' 4 Alternate Phone:
Er Insurance—Current:
1
uLi:suan From-CHI' OF ORONO +H224(616 T-624 PO /O03
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Note: All Geothermal Systems will now require a Site Plan&R.cview by our Building Official.
IS THIS GEOTHERMAL? D Yes ;2: No
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLLNG SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
N. Gas Factory Fireplace Brand Name: _
Wood Burning Fireplace
Wood Stove Model No_:
LI Wood Stove With Flue
VENTILATION
No. Kitchen Exhaust duct recirculating cfm
El No. Bath Exhaust(must have duct outside) cfm
D No. Other Fans: Locations efrn
FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL)
insuuation Removal
Fuel Oil: gallons LI Underground El Inside El Outside
LP Gas: gallons
Other;
GAS LIN'E ONLY
[71 Outdoor Grill Other/List What&Where: 22kW Sit,74e, -10 /Lett),
2 F Aveilaze (Atipfie,o)
Nov-03-2008 09:30an From-CITY OF 0RON0 +9522494616 7-a24 P.003/003 F-35H
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❑ Yes,this section applies
The replacement of a Residential fixor appliance that meets all three of the following requirements:
1. Does not require modifirittion to electrical or gas service.
2. Has a total cost of$500.00 or less;exc din the cost of the fixture or appliance:and
3. Is i>t ,coved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies, Cost of Permit $ 15,00
State Surcharge $ .54
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee
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If above does not apply;follow guidelines below:
1_ CONTRACT PRICE *is L25%of contract price with a(Minimum:Fee of$35.00)
7; x.0125$_ 35:619(contract price) (minimum$35.00)
2. .TATE SURCHARGE t"Add the State Bldg Code Div.Surcharge(Minimum Fee of$.50)
x.0005 $
(contract price) (mmitnum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1 50
4. TOTA[.,PST FEE (Add Lines 1-3 Above) $�_ 3z•09
r *
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 clone. If any material, equipment, labor or installations are f rnisbed by
the owner, tenant or any other parte,the reasonable market value of such items imist be added to the
estimated cost or corlct 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.
• **The STATE SURCHARGE is.0005 of the Building Department at(952)2494600 for the price.
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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