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Home My WebLink About2011-01508 - gas line only • �' CITY OF ORONO PERMIT NO.: 2011-01508 ►, 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 12/02/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 845 WILLOW DR S PIN : 10-117-23-22-0002 LEGAL DESC : UNPLATTED 10 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY VALUATION : $ 1,500.00 NOTE: GAS LINE TO GARAGE METER TO SIDE OF BUILDING APPLICANT MECHANICAL 50.00 BARR WEB INDUSTRIES INC. STATE SURCHARGE MECH(VALUATION) 0.75 3530 E.28TH ST TOTAL 50.75 MINNEAPOLIS,MN 55406- PAID WITH CASH 50.75 OWNER WILLIAMS,ROBERT&JORDANNA 845 WILLOW DR S 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 conform a State Building Code.This permit may be revo any time for du" pplicant Permi g e Date Issued By Si ture Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. FOR CrrY USE ONLY A- City of Orono 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 CITY OF ORONO-MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL INFORMATION I. You may apply for mechanical permits by mail or in person at the City offices. Applications will be reviewed and a permit wiii 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 ❑Additional ❑Repairs ❑Replace Job Site/Owner Information: Site Address: V6_ fl/d/o:,v h r Owner: Mailing Address: City: 0r a V�'_n Zip: 3 S Home Phone: 91 52- 7 70- 0 a 0q Alternate Phone: Contractor Information: Contractor: 6 A�2 t2 Oe S S r1,0. rbc • Contact Person: -T-oh�j Ll c-GsA-t+- Address: L36 i�- 7i S+- State Bond City: m&_6Zip: Expiration Date: 1 ,2-:71 tt 2-e Phone: Iii Z 07-0 Zo Z- Alternate Phone: c Z.F5-6 10 t O 6 ❑ Insurance-Current: o 1 NJILNG IN Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official. IS THIS GEOTHERMAL? ❑Yes ❑No HEATING SYSTEMS Quantity: Make: Fuel: Flue Size: T....jDD.—T... ,,,tpA B 1 V Output BTUs: CFM: Quantity: Make: Model: Tons: ii.v�JCrr FIREPLACES ❑ Gas Factory Fireplace Brand Name: 1_1 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 F1 IA 0 1: gallons ❑ I inrlararnimrl ❑incitiP ❑nLtQ'dp LP Gas: gallons Other: GAS LINE ONLY I-1 n...a i :ii ",tar r�",41h-. D.\iTl _ �� fL, tti / 110.E K. S�ilbf b. %.. 2 UT FEE CALCULATIO LSLAXRSTAJTJE�- � ❑ Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: I Does rift rvgiiir8 iisv dific i3ii t3 ci c`iiv?i 3r gni sviVi . 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 A,mii-iT_Vii ree f ii nVViivav of m �.. Total Permit Fee $ :10N(S)—JOBS OVER$500.0 If above does not apply;follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) 1600 . 06 x.0125$ (contract price) (minimum$50.00) 2. STATE SURCHARGE x.0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMU FEE(Add Lines 1-3 Above) $ * nnXTTn T IT11 Tnv COS' .....ar6 th.. 1 d a li L r i i+A�i r ru�.r. 3r evv ��s suciur� uic ac%ttias 3r v�tiiiuit`.au uGuiu iiiiiviint a�.imrg 13r thee 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 CaL.. •..L t.. Uru L._:....•.._ r a t.. amiount On uie jolt Cosi, uic iiy 1—nay--up uic niivisu�iv»vi 3 Signed wyy uie it%itini Couua?Ct IANICALPERMIT APPLICATION AG 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: t< f 3 TIME CITY OF ORONO LED IN INSPECTION NQTIC SCHEDULED PERMIT NO. �[) COMPL ED ADDRESS OWNERT PHONE CONTRACTOR Y& DESCRIPTION &9'4� (ice ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAWGRADING/FILLING Q El POURED WALL ❑ MECHANICAL RI El LAKESHORE/WETLANDS h ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ElFINAL ❑ SEWER HOOK-UP El COMPLAINT ❑ DEMO-SITE ❑ SEPTIC MAINT ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: cc W 0. cc O U_ W CC Q Z W z W CC ��RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK R PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN El 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. White CopylInspector's File Canary Copy/Site Notice