HomeMy WebLinkAbout2004-P07713 - mechanical � � '� PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 Po��i3
Crystal Bay, Minnesota 55323 Pe►'mit Type: Mechanical Permits
(952) 249-4600 Date Issued: ��is�2oo4
SITE ADDRESS: 4160 Forest Lake Dr
MOUND,MN 55364
P I D: 07-117-23-11-0003
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Mechanical Perniits Permit Sub-type(s): Multiple Mechanical Items
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 87•00 Valuation• $ 6,960.00
State Surcharge Fee: $ 3.48
TOTAL FEE: $ 90.48
APPLICANT: Countryside Heating&Cooling OWNER: L L GOLDEN&T D GOLDEN
6511 Hwy 12 4160 FOREST LAKE DR
Maple Plain,MN 55359 MOiJND MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE 1 UED BY S[GNATURE
Copies: 1-File(Sienitures Required), 1-Applicant, 1-Monthlv Reports. 1-Assessine, 1-Finance Page 1
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CITY �F ORONO APPLICAT�ON FOR MECHANICAI. PERMIT
BoX 66 (2750 ICelley Parkway)
�a-ysta�i Bay, IvfN 55323
GENERl�L INFORMAT'ION
l. You may apply for mechanical pennits by mail or in person at the City offices. Applications
will be reviewed and a permit will be issued within two working days.
2. Pennit cards will be sent by return inail after a review is completed. PERMITS ARE NOT
VALID UNTIL I'OU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desi�ns - 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, n�anufacturer and model. Data shall be presented on forin provided,
Identification of and specifications far 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 worl< inust be done in accordance with the Unifonn Mechanical Code/State Building Code
requirements.
6. All work must be inspected (rough-in and final). Ca11(952) 249-4600. 24-hour notice
requu�ed.
7. House Heating Test Record must be submitted before final.
Ins�ruc�i�ns
Complete all items on this application. Compute the permit fee. Sign and date the
certification. INCOMPL�"TE APPLICATIONS WILL NOT BE PROCESSED. If you
have questions, call (952) 249-4600.
Please check one: New Addition Repair Replace
esidential � Commercial �—
,�OB �I"rE: �� �(� `i-t=R.(~,��'� L,�4-(CC �� V�`�_' zi�: ����
O���ner's li'air►e: �ji'I �[��� Phone Number: SpZ ' 7d ' 0 `
Mailing Address: �(p U �d,Cc:SS�L-� � City• _ /hQu.r�c� Zi
_ P� S's�
Contraetor's Name:��� d�� N�G-- �hone Number: �!�'�" �� �`���O
Maili�g Addres�: _ (d 5ll '7 �,�— City: �/J�L� � 7ip: .�
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SYSTEM DESCRTPTTON
IIEATING SYS'I'EMS �
Quantiry:
Make: ���
Model: ����vG,37"���
Fuel: �� �� _
Flue Sire:
Input BT'Lis: �(/��/�� __ _
Output BTUs _
CFM�
COOLING SYSTEMS �
Quantity:
Make: ��
Model: ��/�X�� -- —
Tons: �
H.Power
FIREPL�CES '
_ Gas factory fireplace
Wood burning factory fireplace with flue
______ Wood Stove
Wood stove with flue
Brand Name Model No.
V�N'TILATION
No. Kitchen Exhaust duct recalculating cfm
No. Bath Exhaust (must have duct outside) cfm
No. Other Fans: Locations cfm
FUEL S"I'ORAGE(MUST BE APPROVED BY FIRE MARSHAL)
Installation or Removal
Fuel oil: gallons underground inside or outside
LP Gas: gallons
Other Gas opening
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PERM4T I;EE CALCULA,T�ON(S)
2002 State Stata�te 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; excludin� the cost of the fixture or appliance:
and
3) Is improved, installed ar replaced by the homeowner or licensed contractor.
Skip next section; Cost of Pennit $ 15.00
' State Surcharge $ .50
Mail-In Fee $ 1.50
If above does not apply, follow guidelines below:
1. Can��-act Price* is .O125% of job with a Minimum Fee of($35.00)
��C�� �.ol2s � S`?• �-
(contract price) (minimum$35.00)
2. S�ate Se�rcd�arge. ** Add the State Building Code Division a Minimum Fee of(� .50)
�p ��D. �i�x .0005 S _�� � °
(contract price) (minimum$.50)
3. Posta�e and Hlandlin� (Only mail-in applicatio�zs) $ 1.50
4. T'O"1'.9�L PERMI'C FEE (Add lines 1-3 above) $ �'
7 v
*CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the pem�itted work �
including materials,labor,profit,and other fixed costs.It is the amount to be charged to the customer for the work
done. lf any material,equipment,laUor,or installation is 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 pennit 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.
**T6e STATE SURCHARGE is.0005 of the contract price under$1,000,000 or$.50-whichever is greater.For
valuations over�I,000,000 call the Department of Inspectional Services for the price.
The undersigned hereby applies to the City for issuance of a Mechanical Pennit,agrees to do all work in strict
accordance with the ordinances�and t re= ons qf the Minnesota State Building Code,and certifies that
all statements made on this applicati are c �1 , rue an ct.
Applicant's Signature: �� Date: 7 � ��
Appro��ed By: Date:
Re�et Forrr�
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DATE�f TIME
CITY OF ORONO CALLED IN ���/ G�
INSPECTION N TICE SCHEDULED ��i�N ' vU/4
PERMIT NO. / 3 COMPLETED
ADDRESS y�(p D f�(1�P �� �^-� �a .
OWNER CONTR. �t/.t�k�ri.�/�-r.�2
TELEPHONE NO. �� � � /% l�i� O�
� DESCRIPTION 1 u��Gcn. I '� ,�J���/���
� 01 FOOTING 11 MECHANICAL.RI,__ 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 1�1G1�ECHANICAL FINAL� 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPIAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �WORKSATISFACTORY:PROCEED �OJECTCOMPLETE
W ❑ CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46QQ
OwnerlContractor
Inspecto
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