The URL can be used to link to this page

Home My WebLink About2013 - 00771 - mechanical CITY OF ORONO Il 1101111 _II II II 11111111 2750 KELLEY PARKWAY * DATE ISSUED: 08/06/2013 k ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2175 WEBBER HILLS RD PIN : 03-117-23-34-0003 LEGAL DESC : WEBBER HILLS : LOT 006 BLOCK 001 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : COOLING SYSTEMS VALUATION : $ 8,000.00 NOTE: 1 LENNOX 2 TON AC APPLICANT MECHANICAL 100.00 TOTAL COMFORT STATE SURCHARGE MECH(VALUATION) 4.00 4000 WINNETKA AVE N SUITE 10 MAIL-IN FEE 2.00 NEW HOPE,MN 55427- TOTAL 106.00 () OWNER MANDY, CHRISTOPHER&NIKOLE 2175 WEBBER HILLS RD WAYZATA, MN 55391- 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. `114 a24 67l,La-.c Applicant Permitee Signature Date Issued By Si ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. FOR CITY USE ONLY i �O ATO City of Orono i V 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 - lgkFSHO��C. CITY OF ORONO—MECHANICAL PERMIT (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 0 Additional ❑Repairs "Replace Job Site/Owner Information: i4' 1 Site Address: �,1 S bb oror � l s i,a Owner:@VIi S m'af at( Mailing Address: Sezt./Wt. City: ()CD no Zip: 5 31 Home Phone: 9 SD. Cil -toy" Alternate Phone: QSa •`77 Lp• (7008 Contractor Information: `� , Contractor: ` 64 4 I aDnn. ( Contact Person: t t vkc(( /Lk\il Address: tfoociW f itiltet State Bond#: Mei 3G,&5 City: 1' OtpeZip:S (flxpiration Date: "`'3o.k' Phone: 1 a3*N". Alternate Phone: (p... .- - 5 CO Insurance—Current: S,Q. poubp.ct ri? '�"�-'�xv ixS'-k �"x'zri�' 4 �@may i` �� -ter ar :x -��f s �e re a:.� � t� s ``:^', ay�>.,� a,,,�. t r'.a�` 3`3 a�n`:' s ,�$'? ,K '<' -,�s<�,,P g :: :.. ^a d ';.r?'r �", s c' P"Y�'r i `'rt'�,}° .,:��'..: Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. IS THIS GEOTHERMAL? ❑Yes ❑No HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: Input BTUs: Output BTUs: CFM: COOLING SYSTEMS Quantity: Make: L ehnb y Model: 'i C1l-O7 Tons: a ,0 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 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 ❑ Outdoor Grill ❑ Other/List What&Where: 2 0 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 $ O9 p ' x ;' w ::i' r to + '' If above does not apply;follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) o x.0125 $ 1.00 t) (contract price) (minimum$50.00) 2. STATE SURCHARGE �bo.� x.0005 $ Li,00(cotitractt price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ k 0 10 .00 • * 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. -,-, ..f t p�F. a4" ^�,,t ama0 ate` ?3 �s „g. 1.��.,w".,$.e , .. . w ' Y'%j.'. AC 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 Signatur •.._./ //v, _ / Date: 05C-o2 'l3 3 A�gO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 8/2/2013 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:CONTACT Jenna Anderson Marsh&McLennan Agency LLC PHONE Ext):763-746-8000 INC,FcNo):763 548-8684 7225 Northland Dr N#300 E-MAIL sanderson Minneapolis MN 55428 j@rjfagencies.com INSURER(S)AFFORDING COVERAGE NAIC 0 INSURER A:The Builders Group of MN INSURED TOTACOM INSURER B:Technology Insurance Company A-ABC Appliance&Heating Inc INSURER C:EMC Insurance Companies dba Total Comfort INSURER D: 4000 Winnetka Avenue North New Hope MN 55427 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:628505856 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. ILTRR TYPE OF INSURANCE "DR WR POLICY NUMBER (MMIDD YYYY) (MMIDDD YYYY) LIMITS C GENERAL LIABILITY 4D93230 6/1/2013 5/1/2014 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PRS(RENTED PREEMMI E SES(Ea occurrence) $300,000 CLAIMS-MADE X OCCUR MED EXP(Any one 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 —1 POLICY X Pyr LOC PD Deductible $1,000 C AUTOMOBILE LIABILITY 4E93230 6/1/2013 5/1/2014 COMBINtO SINULE LIMI r (Ea accident) $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS AUT ONSWNED (PP r accidentDAMAGE $ C UMBRELLA LIAB X OCCUR 4J93230 6/1/2013 3/1/2014 EACH OCCURRENCE $2,000,000 EXCESS UAB CLAIMS-MADE AGGREGATE $2,000,000 DED X RETENTION$10,000 $ A WORKERS COMPENSATION 020001644-MN ONLY 6/1/2013 B/12014 X VVC STATU- OTH- B AND EMPLOYERS'LIABILITY Y/N TARKS48778-KS Only 10/23/2012 10/23/2013 TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVEN/A E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if 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 D REPRESENTATIVE Crystal Bay MN 55323 /27 U ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. arc/.3 -06'277 COMPLETED /O^1.6=/f` ADDRESS off/ 2s kJ€ ¢r hit tic RV- OWNER TELEPHONE NO. CONTRACTOR 7 3Z L ( ,,N-r: rt DESCRIPTION f�C re/0<< • ❑ FOOTING 0 PLUMBING FINAL 0 EXCAV/GRADING/FILLING Q 0 POURED WALL 0 MECHANICAL RI 0 LAKESHORE/WETLANDS " 0 FRAMING 451I AFrHANICAL FINAL 0 TREE REMOVAL 0 INSULATION ❑ WOOD BURNER/FIREPLACE 0 SITE INSPECTION Q 0 RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ❑ FINAL ❑ SEWER HOOK-UP 0 COMPLAINT v 0 DEMO-SITE 0 SEPTIC MAINT 6,3ELLOLLOW-UP Lu ❑ DEMO-FINAL 0 SEPTIC INSTALL ❑ HARD COVER REMOVAL 0 PLUMBING RI ❑ SEPTIC FINAL 0 FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU:_YES NO ca., COMMENTS:cc A// //++ OWeV 7eS c.` -(rcr . +t•re J //l 5©�c- L e.ti.. ° g I ec/rc,t reco✓I hQ c W CC 1J Of« Cbsrle eLtibia/40 W cc IQ ❑WORK SATISFACTORY:PROCEED RQ,IECT COMPLETE CC ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY C5 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR CI CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractoLon site: Inspecto i White Copy/Inspector's File Canary Copy/Site Notice