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Home My WebLink About2012-01229 - mechanical , . CITY OF ORONO * z 0 1 z - 0 1 z z 9 * . 2750 KELLEY PARKWAY DATE ISSUED: 12/07/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4265 FOREST LAKE DR PIN : 07-117-23-12-0016 LEGAL DESC : FOREST ARMS : LOT 008 BLOCK 002 PERMIT TYPE : MECHAMCAL(>$500) PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : MECHANICAL- MULTIPLE VALUATION : $ 1,800.00 NOTE: (1)CARRIER}iEATING SYSTEM-MODEL 58STA-NATURAL GAS 4-6"FLUL-90,000 INYUT BTU'S AND 72,000 OIJTPUT BTU'S APPLICANT MECHANICAL 50.00 SABRE HEATING &AIR COND INC. STATE SURCHARGE MECH (VALUATION) 0.90 15535 MEDINA ROAD PLYMOUTH, MN 55447 TOTAL 50.90 (763)473-2267 OWNER KALWEIT, GEORGE& KATHRINE 4265 FOREST LAKE DR MOUND, MN 55364 AGREEMENT AND SWORN STATEMENT l�hc work for which this pennit is issued shall be performcd 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 aran[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 whe[her or not specitied 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 arc requested in conformance with the Sta[e[3uilding Code.This permit may be revoked at any time for d e cause. � ; i � d-,.� � � � � t 2.- 2� 7 � /�-- Applicant Permite � i ature Date Iss d f3y Signature Datc SEPARATE ERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. d4.5� ' FO ITY USE ONLY ¢p� City of Orono r�� ' P.O.f3ot 6G Date Recei� . � Permit# ��q7"� �� .; 2750 Kelley Parkwa} �j., � p`'r Crystai Bay,MN 55323 Approved By: Amount$: ...J(/�g , °°��,�.a�� Phone(9>2)249-4600 Pax(952)249-4616 �� CITY OF ORONO-MECHANICAL PERMIT (All Commercial pem�its must be approved by the Building Officiul or Inspector and/or l�ire Marshall) GENERAL INFORMATION 1. You may apply for mechanical permits by mail or in person at the City o�ces. 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. PERNIITS ARE NOT VALID UNT'IL YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SCTE. 3. Mechanical Desi�ns—Complete calculations,details and speci�cations 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 obta ined. 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�nal). Call(952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before�nal. TYPE OF PERMIT Check All That A 1 �Residential ❑Commercial (Approval Required) ❑ New ❑ Additional ❑Repairs �Replace Job Site/Owner Information: Site Address: �-�f � ��r+r-�'"3-�-- 1--•��1�1_ �►--� � � .` 1\ Owner: - �� c--7 L�� - Mailing Address: ��S �v{'; � �--�, t-�� City: � 1 Zip: �>��(c� `-t-. Home Phone: C'T�Z ��--- �''�'� Alternate Phone: Contractor Information: � Contractor: ��C.Ic�r� � ��--�`� � Contact Person: � ��,l-t inc' ��a 4-�.��. f� I Address: �� M��a � State Bond#: �\��`�L,�j'�� City: �� Zip��Expiration Date: � � 1 Phone: I�� 2-2--�� Alternate Phone: �Lr� �� j� ❑ Insurance-Current: �►�°,� � 1 . MECHANICAL SYSTEMS BEING INSTALLED Note: All Geotheimal Systems will now require a Site Plan& Review by our Building Official. 1S T1iIS GEOTHERMAL? ❑ Yes �No HEATING SYSTEMS Quantity: � Make: �_�_�j�' ModeL �'��p. Fuel: ��a� . — 1� Flue Size: � InputBTUs: ��Y�a(�� Output BTUs: �Z. ��(�� CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: H. Power FIREPLACES ❑ Gas Factory Fireplace Brand Name: ❑ 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 p/ace.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑Inside ❑ Outside LP Cras: gallons Other: GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List What&Where: 2 PERMIT FEE CALCULATION(S) BASED OFF - 2002 STATE STATUE ❑ Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following reyuirements: 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 or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Permit $ I 5.00 State Surcharge $ 5.00 Mail-In Fee(lf Applicable) $ 2.00 Total Permit Fee $ PERMIT FEE CALCULATION S -JOBS OVER$500.00 If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of 550.00) � l�rC�U , pp X.oias $ ��j ,Cc; (contract price) (minimum$50.00) 2. STATE SURCHARGE /�, I��Y�` x .0005 $ � ��1 V (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $��Z •�� ) ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials, labor, profit, and other�xed 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 amount of the job cost, the City may request the submission of a signed copy of the actual contract. MECHANICAL PERMIT APPLICATION AGREEMENT 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. _ r Applicant's Signatur : �� `� Date: Z Z � � Reset Form � 3 � ` T TIME ✓ CITY OF ORONO CALLED IN �� INSPECTION OT E SCHEDULED �2 � PERMIT NO. �� D/��COMPLETED ADDRESS �� D E�S� CGKJ�-� OWNER W�LEPHONE N0.�5Z �72 � �3� CONTRACTOR •�.=� �� ; DESCRIPTION �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADI G/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREIWETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOA TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W � � � ❑WORKSATISFACTORY:PROCEED �OJECTCOMPLETE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CARRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on ite: Inspector. White Copyllnspector's File Canary Copy/Site Notice