HomeMy WebLinkAbout2018 - 00286 - gas line only CITY OF ORONO I*(1 1 1 1 1 I I g I I1*
2750 KELLEY PARKWAY DATE ISSUED: 03/13/2018
ORONO,MN 55356-
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 1186 WILDHURST TR
PIN : 07-117-23-24-0007
LEGAL DESC : REG.LAND SURVEY NO. 1116
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : GAS LINE ONLY
VALUATION : $ 550.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
GASLINE FOR FIREPLACE
APPLICANT MECHANICAL 50.00
ALL CITY PLUMBING STATE SURCHARGE MECH(VALUATION) 0.28
8100 COUNTY ROAD 110 W TOTAL 50.28
MOUND,MN 55364-
Payment(s)
(612)817-6731 CREDIT CARD 5083 50.28
Minnesota State License#:plbg-PC643613
OWNER
RASMUSSEN,BRIAN&SANDY
1186 WILDHURST TR
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.
3—/ �,� / , _. / — 3 113 / 121
Applicant Permitee Signature Date Issue, :y Signature Date
%'
l4 "1TY USE NLY
y City of Orono l „1�. $`-QQ��
tilt._
v/� p 0 Box 66 Date Received: Ili Ili I? Permit# 0�
I../ 2750 Kelley Parkway ,II�g``II
Crystal Bay,MN 55323 Approved By: ^Ii _ Amount$: ,
Phone(952)249-4600 Fax(952)249-4616 �il1 �
f�lwu
CITY OF ORONO–MECHAN t'a ` L PERMIT
KES HOR (All Commercial permits must be approved by the Building Offi 111 ay
inspector and/or Fire Marshall)
111
GENERALINFORMATION 1, i,
1. You may apply for mechanical permits by mail or in person at the a�`,FG offices, Applications will
be reviewed and a permit will be issued within two working days. Ili
2. Pea cards will be sent by return mail after a review is eomplemd d-12MITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST N 2 '1:EGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE. ;
3. Mechanical Designs–Complete calculativus,details and specifica.,;0.0.•are required for each
heating,ventilation,humidification-dehumidification,and air cond.L . ing installation including
heat loss/heat gain calculation,design temperatures,equipment rat t,and identification as to
type,manufacturer and model. Data shall be presented on form pr `h ed.
4. When any new construction or remodeling is involved,a separate l in;ging permit must be
obtained. 1111141
5. All work must be done in accordance with the Uniform Mechanic• .de/Stare Building Cude
requirements. jil
;I
6 All work must be inspected(rough-in and final). Call(952)249-4.1 1
(24-48 hour notice required)
7. House Heating Test Record must be submitted before final.
I1
TYPE OF PERMIT ! `
(Check All That Apply) '1,
1'111.
residential ❑Commercial(Approval Required) [Backflow - ce:❑AVB ❑PVB]
I
0 New %f Additional 0 Repairs I� 0 Replace
I,
I
i
Job Site/Owner Information: ri I
Site Address: 1/ 56 (1J, v/r-5f / '!. 1
Owncr:J Mailing Address:I I 15-3 5
li
City: Zip:
IlHome Phone: _ _ Alternate Phone: I
Contractor Information: ,I i
II
Contractor: Ari< C1 N Ptu 3 0)v-- Contact Person: I� 2 c
1
Address: giOt1 Cp.- N 0 W State Bond#: II. P\ ,00 T)`i3—
I
,'/� `� /o`7� tlrz
City: l `' � �Y'ih' Zip:S"s `/ Expiration Date:. i
11Phone: C z"�I�' Alternate Phone i1 j
ii
F Insurance–Cu !� .. V'
1
i'
it[1
Se/EO 3Jdd 9NIgWflid AlIO 7-d ZZ6IEZ6Z96 SV:OT 8T0Z/ZT/E0
•
I! II'
iI
I,
Plan&Revie i'i'i„ our BuildingOfficial.
Note:All Geothermal Systems will now require a Site
IS THIS GEOTHERMAL? ❑Yes ❑No 'll
III
HEATING SYSTEMS j! I
Quantity: 11 1
i
1;111 11
Make: ...;4 11
All I
Model:
fuel:
Flue Size: 77- 'i'
Input BTUs. _.
ii i
/ it
Output BTUs: // 'I i"
X .'I
CFM: G f `� ,,_
�l
COOLING SYSTEMS l
f,l
Quantity: . 1
%i
Make: i 11
Model:
Tons: �1 i
H.Power
n,
FIREPLACES
FIREPLACES
❑ Gas Factory Fireplace Brand Nam4
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:�i W
❑ Wood Stove with Flue/Masonry 1
i
VENTILATION
i
❑ No. Kitchen Exhaust duct ii circulating cfm
O No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations ctm
FUEL.STORACJ (Must be approved by Fire Marshall lf`proposing to don tank in lace_)
❑ Installation ❑ Removal
I ;
Fuel Oil: gallons ❑ Underg • d ❑Inside ❑Outside
LP Gas: gallons 1
Other: I
Ii
GAS LINE ONLY ( I1
Other/List What&Where: nil re la , LF L
LI Outdoor Grill k
2
II
�14/tilk1 dJt7d EJN1HALL)l I Id AII IV Gb LE:6b6 b hP:14 L 8 LId6/6 L/bU
•
II1i��
ii111
PERMIT;F E.CALCULATIONS
1. CONTRACT PRICE *is 1.25%of contract price with a(Mi": urn Fee of$50.00)
550
(Contract price) !,j (miplmum$50.00)
II'
2. STATE SURCHARGE ;.
x.o(;!, $
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) li id $ 2.00
'I' k
!'i 1
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) ',II $
■ * CONTRACT PRICE or JOB COST means the actual or estimated1�'j lar amount charged for the
permitted work including materials,labor,profit,and other fixed costs; �u,1 is the amount to be charged
to the customer for the worK done_ If any material,equipment,labui or 11.l1ations arc fuished by the
owner, tenant or any other party, the reasonable market value of s "I rnMems must be added to the
estimated cost or contract price for permit fee purposes. In the event that re is a dispute on the amount
of the job cost, the City may request the submission of a signe I j B:opy of the actual cttttttact.
11
MECHANICAL PERMIT APPLICATION AG. ..:EENT
1
The undersigned hereby applies to the City for issuance of a Mech• •al Permit, agrees to do all
work in strict accordance with the ordinances of the City and th;'i� gulations of the State of
Minnesota,and certifies that all statements made on this application 'i omplete,true and correct
O �
Applicant's Signature- t. ji
-/
:1i,Ii
q
k,
3
1,l
50/50 3Jdd 9NIHN111d AID 11V ZZ6t8ZEZ56 517:0t 8t0Z/ZI/£0
DATE TIME
ITY OF ORONO CALLED IN
INSPECTION Nang SCHEDULED .-19-/$ 36
PERMIT NO. t=20?5 - 0 0"`-0
(COMP ED
UL
ADDRESS Il o (C)
OWNER AELEPHONE NOka gi510_ek0a.
is
CONTRACTOR 'OECD; ''71/ J y m" rk
DESCRIPTION
W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
❑ FOUNDATION DRAIN TILE 0 PLUMBING FINAL 0 TREE REMOVAL
• ❑ LATHE 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
• ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
• 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
✓ ❑ DEMO-SITE 0 SEPTIC INSTALL
• OWNERICONTRACTOR TO MEET YOU:_YES_NO
col• COMMENTS:
cc
a.
Coe poi 44 114 -e, for- /!mss Fp.
cc cdee k. y
o so a'. -d 404,6 -,
cc
•=113- cbdfri•fzfW
2
SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
'❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
C3 0 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 ❑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. 9/n.
White Copy/Inspector's File Canary CopylSIte Notice