HomeMy WebLinkAbout1996-008625 - replace furnace _ � PERMIT �
• CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 ' ' �`�='='-'`=
Crystal Bay, Minnesota 55323 Permit Number: ��_��?����:,�°'�_
(612) 473-7357 Date Issued: � ;�'j ?�,.".-%
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT-PERMITEE SIGNATURE ISSUED BY:SIGNATURE . ��.
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CITY OF ORONO APPLICATION FOR MECHA2vICAI. PERM�r
Box 66 (2750 Kelley Parkway)
Crystal Bay, N1N 55323
GEi�1ERAL 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 compieted. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGiN UNTII., THE PERMIT CARD IS
POST'ED ON THE JOB SITE.
3. Mechanical DesiQns - Complete calculations, details and specifications are required for each heatin„
ventilation,humidification-dehumidification, and air conditioning installation including heat loss/heat gai.n
calculation, desi,gn temperatures, equipment rati.ngs and identification as to rype, 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 obcained.
g, All work must be done in accordance wi� �e Unifo:m M�hanical CedelState Buildine 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 perm.it 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 �Replace
Residential Commercial
JOB STTE: � S�O ” o�-e��l'� �p'
Owner'sName• � < � TelephoneNumber: � 7a —�l � / 3
Mailing Address: 4 _ `c� �u't-t�' u City: Zip:
Contractor'sName• - �' �-� TelephoneNumber: S 3 � —�5��/
MailingAddress: �� /2 i ����'� 7� City:C`'%z. .�� Zip: S.s� �z �
SYSTEM DESCRIPTION �
HEATING SYSTEMS
Quantiry: �
Make: I �`�'
iviodel: �i t� �/ �- s -
Fuel: ��'I�c,.� ��
Flue Size:
Lnput BTUs: i a �i o r' `'
Output BTUs: //ic? D tI ei
CFNI:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H. Power
— �
����
_ � " a►.
WOOD JBURNING 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 Mi.n., Clearances, side , rear , min. flue dia.
Tatal
VENTILATION
No, Kitchen Exhaust ducteci recirculating ��
No. Bath Exhaust (must be ducted outside) ��
No. Other Fans: Locations �� -
. Totat
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 Pricek or Niinimwai �'� 1�.:�5.v�-��
/�� dv , �� c� x .0125 $ �C'�� U �'
{contract pr,'ce)
2. State Surchar�e. ** Add the State Buildi.ng Code Division ���
Surcharge to each permit. / o C��� _ x .0005 $
(contract price)
or $.50, whichever is greater � � ��
3. PostaQe and Handlina (Only mail-in applications) $
4. TOTAL PERMIT FEE (Add lines 1-3 above) � � � � 3��
* CONTR.AC'T PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted
work including materials, labor, profit, and other fued cosu. It is the amount to be charged to the
customer for the work done. If any material, eauipment, labor, or installation are furnished by the owner,
tenant or any other parry 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 cnst,
the City may request the submission of a signed copY of the actual contract-
** The STATE SURCHARGE is .Q005 of the contract price under $1,QOO,Q00 or $.SO - whichever is
greater. For valuations over $1,000,000 ca11 the DePart�ent 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.-___.._.___ ,
_ _ � _- �r�..� :;: �-c..��_ �c� Date: �a � 1 '��
_ Applicant's Signature:
_ Date:
APProved By: - �
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DATE TIME
CITY OF ORONO CALLEDIN /�/-z-`��'�
INSPECTION N�TICE SCHEDULED / / °/9., ;
PERMIT N0. � � COMPLETED lL 3J -Cj'� Q_'
ADDRESS �U �di� � G�'•
OWNER ������� CONTR.��o����
TELEPHONE NO. 'S�7`� -L� -3 `��-i�,�z�� I .��� �
� DESCRIPTION /
� 01 FOOTIN(3 it MECHANI 18EXCAV/dRADIN(3/FIWNO
�Q 02 FRAMINO 13 MECHANICAL FINAAL: 19 LAI�SHOREIWETLANDS
Q 03 INSULATION 2 D BURNERIFIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
� 05 FINAL 14 SEWER HOOK-UO 06 PROGRESS
_
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
� 07 DEM�FINAL 75 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINO FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU: YES�NO
� COMMENTS:��� 1�.��� -� ��Z'L���L
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d�ORK SATISFACTORY:PROCEED �pROJECT COMPLETE
W
�' ❑CORRECT WORK 8 PROCEED fi� ISSUE CEfiTIFICATE OF OCCUPANCY
��Y
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETUAN `
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnerlContract o
Inspector. /
White Copylinspector's File Canary CopylSite Notice
H USE HEATING TEST RECORD
ADDRESS � � � ` � l APT. FLOOR CITY SUBURB v�'��U
OCCUPANT � � OWNER
HEAT LOSS DA HTG. INST.
SOLD BY INSTALLED BY c SU�lc<2 ��z /�c.�:r�a
El�etricol Wer� B� .2/r/^�'n-- /—` e� <— Gas Lin� Br
TYPE OF HEAT GA FA�NW STEAM SPACE HTR. UNIT HTR. OTHER
-� GAS DESIGN CONVERSION
MAKE ��-�y` � MAKE OF BURNER
Mod�l L — � Model
S�rial `' yG '31�� ��� 3 Mox. BTU Rotiny
INPUT �c��IG�OD MAKE OF FURNACE
Model
CONTROLS j � // DEC =� v
THERMO TAT� Hsat Pluy - � V�nt Size
Volv� �-� KIND OF LINER SIZE�NONE
Limit - � Draft Hood y, ReyulaTor
G �/y��x 1 ��umber,
Limit S�ttiny Fiiters Size
Fon Settiny � Chimn�y Locatlon Insids Outside
Pilot Type � �" � Chimnsy Construction �/'��
Pilot Make
Pilot Model Smok� Bo�b Wirinp
Pilot TiminQ 'a Draft °�'/�o� T�st Tay
L.W. Cut Off Door Pressurs Liyhtiny Inst.
/
Prossure P�rcent C0� Date Tsatsd - ��
Input CFH � P�rc�nt O� Company Testing u r
Stack T�mp. ��� U P�rc�nt CO Name of Testsr
Form 235