HomeMy WebLinkAbout1995-007442 (Gas Line) _ _ _ _
� P�RMIT
. CI�'Y OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 - -��=;;�,:_ :.��:�..
Crystal Bay, Minnesota 55323 Permit Number: ,'�,>',;;,�-� ` `
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(612)473-7357 Date Issued: _ - - -
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: - - :. .�_ =.�;-�f_ - OWNER:
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, `� APPLICANT'PERMIT E SIGNATURE \ ISSUED BY:SI NATURE �
CITY OF ORONO APPLICATION FOR MEC�IANICAL PERMTT
Box 66 (2750 Kelley Parkway)
Crystal I3ay, MN 55323
GENEItAL INI�ORMATION
L You may apply for mechanical permits by mail or in person at the City offices. Applications will be
reviewed and a per►nit will bc issued within 2 working days.
2. Pcrmit cards wilt be scnt Uy return mail after a review is comple[ed. PERMI'1'S ARE NOT VALID
UNT1L YOU RECEIVE A PERMI"I'. WORK MUST NOT BEGIN UNTIL 'fHE PERMIT CARD IS
POSTED ON THE JOI3 SITE.
3. Mechanical Desiens - Complete calculations, details and specifications are reqtiired for each heating,
ventilation, humidification-dehumidification, and air conditioning installation including heat loss/heat gain
calculation, design temperatures, equipment ratings and identiCication as to rype, manufacturer and modcl.
Dat1 shall be presented on form provided. Identification of a�id specifications for water heati�g equipmcnt
shall also be provided.
4. When any new construction or remodeling is involved, a separate building Permit must be obtained.
5. All work must be done in accordance witli thc Uniforcn Mechanical Code/State Building Code
requirements.
6. All work must be inspected (rough-in and tinal). Call 473-7357. 24-hour notice required.
7. Iiouse Hcatin� Tcst Record must be submitted before tinal.
Instructions Complctc all items on this applicalion. Compute the pennit fee. Sign and datc thc certification.
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have qucstions, call 473-7357.
Please clieck one: New Addition Repair Replace
Residential Commercial
JOI3 SI'TE: f � � )<,:�,' ''��: �' ; Zi � �i',�
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Owner's Nae�ie:�l�l�— ���.���C�� TelephoneNumber: '��� 7J�;�
Mailing Address: /��l��� �, r���.z,,•,� �����! City: � �� � ; , ,_ Zip %��3�%
Conti•actor'sName: f'r�����-z� c.�;_� j,� ��v�i 5 TelephoneNumber �;��-������
Mailing Addi-ess: �rt�,��;, �, ,, , ��;�;� City: << _ :; Zip. ���_��'7�!
SYSTLM DESCRIPTION
�IrATING SYSTEMS
Quantily:
Make:
Model:
l�ucl:
I�lue Size:
Input BTUs: _
Oulput B`I'Us:
CFM:
COOI_,ING SYST�MS
Quantity:
Makc:
Model:
Tons:
�-I. Power
__- WOOD BURNING EQUIPMENT
Wood stove with flue
Wood combination or add-on
I�acto�y f�ireplace with flue
Factory Fireplace (s) Freestanc]ing Masonry
Wood Stove (s) � Franklin, other
Brand Name Model No.
Mf r's Min., Clearances, side , rear , min. flue dia.
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�F�_�����I �' �i-S �;l `j �� �-�� `� (•���� � L`� •� � � c ?�.C� � L.
V�NTILATIQ� �l � ' '��
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) efm
No. Other Fans: Locations cfm
rU�L STORAUE (MUST BE APPROVED BY FIRE MARSHAL)
Installation Removal
Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PCRMIT F�� CALCULATION
1. 1.25% of Contract Price* or Minimum rce ($35.00) ` �_<'
��. � c.�� x .0125 $ ��� >
(contract price)
2. State Surcharge. ** Add the State Building Code Division ���'
Surcharge to each permit. x .0005 $ �
or $.50, whichever is greater (contract price)
3. Posta�e and Handlin� (Only mail-in applications) $ 1.50
4. 'I'OTAL PLRMIT FI?� (�1dd lines 1-3 above) $ =��:`'—`y
* CONTRACT PRICE or JOB COST mcans thc actual or estimatcd dollar amount chargcd for thc��cnnittcd
�vork including materials, labor, profit, and other fixed costs. It is the amount to be charged to the
customcr for the work done. If any material, cquipmen[, labor, or installation are furnished by Nle owner,
tcnant or any other party the reasonable marke[ value of such items must be added ro thc estimated cost
or contract price for permit fee pumoses. In the event that there is a dispute on dle amount of the job cost,
thc Ciry may request the submission of a signed copy of the actual contract.
** The S"1'nTG SURCIInRGG is .0005 of thc contract price undet $1,000,000 or �.50 - whichever is
greatcr. For valuations over $1,000,000 call the Departinent of Inspectional Scrvices 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. � � � : ; /"
, � � "`/� �.�._� Date: /����--��
Applicant s Signature: -
Approved By: Date:
DATE , TIME
CITY OF ORONO ca��Eo iN /�� /� %'> �%"�� ti'�'
INSPECTION NOTICE scHEou�Eo !' -%I=['�` `,">� '�`�'�' �=�� �
PERMIT NO. /�'�X� COMPLETED �Sj �
ADDRESS ` �
�` ��-j � �-' ��� � ,- t��"z�
OWNER �=� ! /� c�-�`i CONTR. f��c,t�.�t >--� -��tu1
TELEPHONE NO. '��� `� � .��` ���x=��
� DESCRIPTION � "�Y;_ ' °� r
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
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Q 02 FRAMING � MECHANICAL FINF� 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPtACE 34 TREE REMOVAL
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Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 D - E 27 SEPTIC MAINT. 21 COMPLAINT
v F 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 B NG 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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W� WORK SATISFACTORY:PROCEED �!_- PROJECT COMPLETE
W CORRECT V��ORK 8 PROCEED �' ISSUE CERTIFICATE OF OCCUPANCY
� Ci CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. i- PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call fo ex inspection 24 hours in advance.473-73�J7
OwnerlContrac r on i � :
Inspector.
White Copyllnspector's File Canary CopylSite Notice