HomeMy WebLinkAbout1995 - 007582 - mechanical PERMIT
CITU OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number: t"..ff::;Qi.:JON CAL.
Crystal Bay, Minnesota 55323 Date Issued: 1 1 11:1::
(612)473-7357
SITE ADDRESS:
34s WILLOW DR
.jE7,5
F• I N . : 20-117-23-22-0001
DESCRIPTION:
1 HEATING !:-..-.NSTEMS FUEL NAT(JFi S MAKE F A RS
MODEL CiMP017S T NPUT 7.f; 000
REMARKS:
FEE SUMMARY:
N $1 , 500
Base Fee.? $35.00 MAIL IN
r r e c TO t.ii.
Si4h.rtota
CONTRACTOR: App]. i rant. - OWNER:
RON MECH I NC: :134458565 OS GO on LARRY
1 .1 OLD Efen YARD RD DR
SHAKOP MN 79 ORONO 55:7-91
Cr
THE
2) 4 4 85 85 4 E.,8 64
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THE UNDERSIGt4ED- HER,E :'?, fiE0t-JEST 3 F.FRtti:s.... ipN,
SPECIFIED AND AGREES-- TO 0(.1 ALL WoRKANSTRItT OLIMPLIMet-
ORONO ORD I NANCES AND STATE, OF MINNESOTA BUILDING- CODE:kent-)1ROMEWO,',1,:'; '," "-`•
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If
1),,,, 4-,, . R HOUSE HEATING TEST RECORD
ADDRESS ' A / APT. LOOR TY 1 U I SUBURB
OCCUPANT OWNER //� S QOn./ / Y
HEAT LOSS' DATE HTG. INST. r �►-` . /�
SOLD BY '.3 )4".•1"........f...45-' INSTALLED BY tfff- S ,/ iJ�_aiiiir a-.`'
Electrical Work By /071k Gas Line By
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
yfri14.4"."
CON ERSION
MAKE 75.'16 S MAKE OF BURNER ,
Model 9 � �� Model
Serial Max. BTU Rating
INPUT / / a 0 MAKE OF FURNACE
Model /
NT ��
THERMOSTAT Haat at Plug Vent Size y
Valve KIND OF LINER /r SIZE NONE
Limit Draft Hood / Regularor /
Limit Setting Filters Size /���Q7( Nu er
Fan Setting
11)41
Chimney Location 1 si4 /fr�� ) de
PiIt Type imney Construction �
Pilot Make
/1/$)
� t ,
Pilot Model iiffictio, Smoke Bomb Wiring- Pilot Timing Draft • Test Tag p
L.W. Cut Off j 4' Door Pressure A_ Lig g Inst.
,,,,,,V
'.Pressure Percent CO 2 ! ' Date Tested ! e t.11p5 / • /
(Input CFH Percent 02 "JO Company Testing ,si '1!A► : �'
/ ` )
,Stack Temp. 'r---r— V �f"�
Percent CO Name of Tester !,'�`
Form 235
I
C'
CITY OF ORONO APPLICATION FOR MEC ; 12�.. �
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
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 2 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. Identification of and specifications for water heating equipment
shall also be 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 473-7357. 24-hour notice required.
7. 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.
Please check one: New Addition Repair XX Replace
XResidential Commercial
JOB SITE: 345 WILLOW DRIVE N Zip: 55356
Owner's Name: LARRY & PEARL O S GO O D Telephone Number: 473-6364
Mailing Address: 345 WILLOW DR N City: ORONO Zip: 55356
Contractor'sName:RON' S MECHANICAL, INC . TelephoneNumber: 445-8585
MailingAddress: 12011 OLD BRICK YARD RD City: SHAKOPEE Zip: 55379
SYSTEM DESCRIPTION
HEATING SYSTEMS
Quantity: 1
Make: 5ii97ZS
Model: 6/MOD/75-
Fuel:
5-
Fuel: /U.Cs•
Flue Size:
Input BTUs: r/5,oO')
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons: •
H. Power
WOOD BURNING EQUIPMENT
Wood stove with flue
Wood combination or add-on
Factory fireplace with flue
Factory Fireplace (s) Freestanding Masonry
Wood Stove (s) Franklin, other
Brand Name Model No.
Mfgr's Min., Clearances, side , rear , min. flue dia.
Total
VENTILATION
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. Other Fans: Locations cfm
Total
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation Removal
Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
a x .0125 $ .35-,64
(contract price)
2. State Surcharge. ** Add the State Building Code Division
Surcharge to each permit. 7�6U. a) x .0005 $ , /C
(contract price)
or $.50, whichever is greater
3. Postage and Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 7,2 y
' 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 installation 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.
** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is
greater. For valuations over $1,000,000 call the Department of Inspectional Services for the price.
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 Minnesota
State Building Code, and certifies that all statements made on this application are complete, true
and correct.
Applicant's Signature/ ; j 0./,_ Date: /0//3�?
I
A roved B Date Sb oto/
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