HomeMy WebLinkAbout2015-00567 - fuel storage tank removal •
• CITY OF ORONO II I 1111 I I 111 I 1111111111
* 2015 - 00567 *
2750 KELLEY PARKWAY DATE ISSUED: 05/12/2015
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 625 FERNDALE RD N
PIN : 36-118-23-11-0021
LEGAL DESC UNPLATTED 36 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FUEL STORAGE TANK REMOVAL
VALUATION : $ 1,500.00
NOTE: INSPECTIONS ARE DONE BY FIRE MARSHALL,JAMES VAN EYLL.
PLEASE CALL JAMES VAN EYLL DIRECTLY AT:(952)473-9701 TO SET UP AN INSPECTION.
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 0.75
ABLE EXCAVATING MAIL-IN FEE 2.00
15630 OLD BRICK YARD RD.
SHAKOPEE,MN 55379 TOTAL 52.75
(952)445-7432 Payment(s)
Minnesota State License#: BUIL-077992-RP CREDIT CARD 4172 52.75
OWNER
GLAD,CARSON&KAROLIEN
625 FERNDALE RD N
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.
Ll'y�aejej / / / /s-
Applicant Permitee Signature Date Issu By Signature Date
O�r City of Orono c rY USE ONL]
WP.O.Box 66 Date Re eiv 1` �7 permit f!CA!)/516D5((-77
2750 Kelley Parkway /�
Crystal Bay,MN 55323 Approved By; t7•d Amount$:
Phone(952)249-4600 Fax(952)249.4616
Z CITY OF
kESHot` ORONO--MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
1 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 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 co ditioning installation including
heat loss/heat gain calculation,design temperatures,equipment atings and identification as to
type,manufacturer and model. Data shall be presented on form rovided.
4. When any new construction or remodeling is involved, a separat,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)
DYR csidential ❑Commercial(Approval Required) gem at,
❑New ❑Additional
0 Repairs ❑Replace
Job Site I Owner Information:
Site Address: 62,3" f«ne /c__ "reZ 7y
Owner: ke.7A/r e ti ‘ /4J Mailing Address: N12-C ft,a
City: O{`Dat6 Zip;
Home Phone: Alternate Phone:
Contractor Information: I
Contractor: ite2AZc a acc ., Contact Person: fill ayn c 49 4:c i it_
Address: /3rc�30 0/�,(�r 4. l
y� State Bond#:
City: $'.41/gyp ez Zip: —Expiration
/� p: Expiration Date:
Phone: '9.51--.2. YVS - 7 V3� Alternate Phone:/f aJot `2"3Z-/ 'gV
ainsurance—Current:
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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;excl udine 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
I $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Ap licable) $ 2_0Q
Total Permit Fee $
u'rIktC ',A. rOrr
If above does not apply;follow guidelines below:
I. CONTRACT PRICE *is 1.25%of contract price with a(lil'Ilnimum Fee of$50.00)
64'-4€1 � .0125$ Jar:?-C
(contract price) (minimum$50.00)
2. STATE SURCHARGE
Acc90 r x.0005 $ 7 6—
(contract price)
3. POSTAGE&I-IANDLING(Only on Mail-In Applications) $ 2,00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) 50
• * 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 doneif any material, equipment, labor or installations are furnished by
the owner,tenant or any other party, the reasonable market value of uch 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 sigted copy of the actual contract.
AP:
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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.
I �Q
Applicant's Signature: id Dae: 6--/g/Z-- /C"
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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:
_ t
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
❑ Gas Factory Fireplace Brand Namd:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen Exhaust duct . recirculating c
frn
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations
cfm
FUEL STORAGE (Must be approved by Fire Marshall ifproposing to abandon tank in place.)
❑ Installation Removal
Fuel Oil: �O �+ gallon
27.70141N9
grUndergrolind
LP Gas: gallons ❑Inside �.Qutside
Other:
GAS LINE ONLY
0 Outdoor Grill ❑ Other/List What&Where:
2
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