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Home My WebLink About2011-00047 - mechanical � CITY OF ORONO PERMIT NO.: 201�-00047 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ►SSUE�: OU25/2011 (952) 249-4600 FAX: (952) 249-4616 ' ADDRESS : 4215 FOREST LAKE DR PIN : 07-117-23-12-0026 LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN : LOT 004 BLOCK 003 PERMIT TYPE : MECHANICAL(> $500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : MECHANICAL - MUI.TIPLE VALUATION : $ 3,100.00 NO�I'L: I TRANE NA'1'GAS PURNACE APPLICANT MECHANICAL 50.00 ROY N. WELTER HEATING CO. STATE SURCHARGE MECH (VALUAT[ON) 5.00 4637 CHICAGO AVE. S MINNEAPOLIS, MN 55407- MA[L-IN FEE 2.00 (612)825-6867 MISC FEE 0.00 TOTAL 57.00 OWNER PAID WITH CC# 0206 LOUGLIN,JOHN & RUTH ' 421� FORESI� LAKE DR MOUND, MN 55364 AGREEMENT AND SWORN STATEMENT The�a�ork 1or��hich this pennit is issued shall be perfonned according to the approved plans and specitications,applicable City approvals,and the State 13uilding Code. 7'his permit is for only the�vork described and does not brant permission for additional or related��°ork which rcquires separate permits. All provisions of laws and ordinances govemine this type of work shall be compied with whether or not specificd hercin."I'his permit will expire and become null and�oid if construction authorized is not commenced wiUiin 180 days ofthe date of issuance,or ifconstruction is suspended for a period of 180 days at any time aftcr work has commenced. The applicant is responsible 1or assuring all required inspections are requested in conlormance with the State Building Code.This pennit may be revokcd at any time 1or due cause+ ��'C-�'e �., / / l l Applicaut Permi[ee Signalure Date Issued �.ignature Date SEPARATE PERMITS REQUIRED FOR WORK OTH R THAN DESCRIBED ABO E. FOR CITY USE OnLY O¢p�p City of orono P.O.Box 66 Da[e Recerved: Permit# �� 750 Kelley Parl:wuy � .� t y'�• �'� Crystal Bay,MN 55323 Approved By: Amou��t$: .d� ' •.; o' � (952)249-a600 .. t4kE9H��4... CiTY OF ORONO —MECHANICAL PERMIT (�111 Commercial pennits inust be approved by dic Building Otticial or(nspcctor and/or Fire Marshall) GENERAL INFORMATION 1. You inay apply for mechanical pennits by mail or in person at the City oftices. Applications will be revie�ved a�ld a perulit will be issued within two�vorki�lg days. 2. Permit cards will be sent by return mail after a revie�v is con�pLeted. PERMITS ARE NOT VALID UNTIL YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMiT CARD IS YOSTEll ON'fHE JOB SITE. 3. Mechanical Desi�ns—Complcte calculations, details and specifications are required for each heatin��,ventilation,humidification-dehumidification, and air conditioning i��stallation including l�eat loss/l�eat gain calculation, design ten�peratures,equipment ratiugs and identification as to type, mantifacturer and modeL Data shall be presented on form provided. 4. When any ne�v construction or remodeling is involved, a separate b�lilding pennit must be 017tA1 I1CC�. 5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code rcquirements. 6. All work mttst be inspected(rough-in and fival). Call (952)249-4600. (24-48 I�our notice required) 7. House Heating Test Record must be subnlitted before finaL. TYPE OF PERMIT Checic All That A 1 ) [s]�Residential ❑ Commcrcial (A�proval Required) ❑ New ❑ Additional ❑ Repairs ��Replace Job Site / Owner information: Site Address: `7`!�l�� Ci�'LS� `jd� ��//,� IA�� / l� G`r'111, �-. Owner: � �,_(��-( Ch /��,�/�,f ivlailing Address: J/�i�1�y - � � L ciry: i�D�l,� zip: J ��.�- Home Phone: �5,� • �7,��.� Alternate Phone: ��"'�L Contractor Information: ' 1 � Contractor: ��1,��_�;��,��S��C�i(,��L: Contact Person: ��(�-I� � Address: ��j�� H�(�,IG�� ✓Il•�� State Bor�d#: L/�0��y�i3 �1 r City: ��' Y�� Zip:JSy�� Expiration Date: �'' `� � - 1 � Phone: �1,�� '��.�LJ Alternate Phone: �� ❑ Insurance — Current: �1�/U C i�,'A."�i+� �'��'' 1 12 i c✓ .:.ti'L � ' MECHANICAL SYYSTEMS BEING INSTALLED HEATING SYSTEMS Quantity: _ Make: � /�/�� ModeL• �L��U� FUe�: I�� 1� F�Ue s�ze: ��>n,'ti�L1 �i�C �l 1 i.�,1� Input BTUs: �� Output BTUs: ��f �(iv CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: H. Power FIREPLACES ❑ Gas Factory Fireplace ❑ Wood Burning Fireplace ❑ Wood Stove ❑ Wood Stove With Flue Brand Name: Model No.: 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) ❑ ]nstallation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List What& Where: 2 I . PERMIT FEE CALCULATION(S) � BASED OFF - 2002 STATE STATUE ❑ Yes, this section applies Thc replacement of a Residential fiature or�liance that mcets all Chrec of thc following requirements: l. Does not reqtiire modification to elecf��al or gas service. 2. Has a total cost of$500.00 or less; exclud�r�the cost of the fixture or appliance: and 3. is improved, installed or replaced by the hoirieQwner or licensed coi�tractor. Skip next scction, if this applies; Cost of PerniTt $ 15.00 State Surcharge $ .50 Mail-[n Fee (If Applicable) $ 2.00 'Cotal Permit Fee $ PERMiT FEE CALCULATiON(S) -JOBS�OVER $500.00 [f above does not apply; follow guidelines below: 1. CONTRACT PRiCE * is 1.25%of contract price with a(Minimum Fee of$50.00) -, 0� �� _�,�L�l� X .o t 2 s s `.�C� (contract price) (minfmum��0.00) 2. STATF. SURCHARGF, ** Add tl�e Statc Bldg Codc Div. Surcharge (�iinimum Fee of$.50) /31 � � � � ,�.G � ,5_ �� , X .000s � t - (contract price) (mininmm� .50) 3. POSTAGE& NANDLING(Only on Mail-in Applications) � 2.00 �r �S- 4. TOTAL PERN[IT FEE (Add Lines 1-3 Above) $ —� � ■ * CONTRACT PRiCE or JOB COST means the actual or estimated dollar amount charged for the permittcd work including materials, labor, profit, and other fixed costs. Tt is d�e amount to bc charged to the customer for the work done. (f any material, equipnlent, labor or installations are furnisheci by the owner, teuant or any other party, the reasonable nlarket value of sucl� ite�us iuust be added to the estimated cost or coiltract price ior permit fee pw-poses. In the event that there is a dispute oi� the amount of the job cost, the Ciry may request the submission of a signed copy of the actual contract. ■ ** The STAT� SURCHARGE is .0005 of the Building Department at(952) 249-4600 for the price. MECHANICAL PERMIT APPLICATION AGREEMENT � � The under-signed her-eby applies to the City for issuance of a Mechanical Permit, agrees to do all work i�l stcict accordance with the ordinances of the City and the regulations of the State of Minnesota, a�ld certifies that all stateule�lts made on this application are complete, tiue and correct. 1 ld� , Applicant's Signature:--��"`�� '� .L�`� � _ Date: � � �� — �� 3 � DAT TIME � CITY OF ORONO CALLED IN � INSPECTION NOTICE SCHEDULED S- —// � PERMIT NO.a��— DOG �� COMPLETED �`' '� ADDRESS��15 �� t L`�-� � OWNER �� u ��'" TELEPHONE NO.gSZ" �"�Z -�� CONTRACTOR �G � �� >; DESCRIPTION � � l� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FIL�ING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FtNAL ❑ SEWER HOOK-UP ❑ COMPIAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ING RI L ❑ FOUNDATION/REMOVAL � O NERI ONTRACTORTO EETYOU: YES NO � MMENTS: � W a � J O a � O � W � Q � Z W � W � � �WORK SATISFACTORY:PROCEED C7 PROJECT COMPLETE 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.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� Z49-4600 OwnerlContract i : Inspecto White Copyllnspector's File Canary CopylSite Notice