HomeMy WebLinkAbout2011-01280 (mech) •� • CITY OF ORONO PERMIT NO.: 2011-01280
2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE �sSUEn: 10/20/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 3640 BAYSIDE RD
PIN : OS-117-23-21-OOII
LEGAL DESC : RIEDEL CO STUBBS BAY ADDN
: LOT 001 BLOCK 001
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 8,900.00
NOTE: (1)SLANT FIN HLATING SYST�M
MODGL-S-120
NATURALGAS
120.000[NPUT aTU'S
APPLICANT MECHANICAL 111.25
SODERLIN PLUMBING STATE SURCHARGE MECH (VALUATION) 4.45
3612 CEDAR AVE S
MINNEAPOLIS, MN 55407- MAIL-1N FEE 2.00
(612)721-4080 TOTAL 117.70
PAID WITH CC# 1868
OWNER
OLSON, HERBERT&JANE
3640 BAYSIDE RD
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
I he work for which this permit is issued shall be performed according to
Ihe approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or rela[ed work which requires separate
pcnnits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or no[specitied herein. l�his permit will
expire and become nidl and void if cons[ruction authorized is not
commcnced within 180 days of the date of issuance,or if construc[ion is
suspended for a period of 180 days at any time after work has commenced.
'I'he applicant is responsible for assuring all required inspections are
requested in conYonnance with the State Building Code.This permit may be
revoke at any time for due � use.
1 D � �� l / �� � �,D� �
Applicant Permitee Signature Date Issue By ignature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
10/20/2611 08:27 6127218091 SODERLIN PAGE 02105
r+c�� .TTv us�oN�Y
Cit,y of Orono /
: ¢�� ` V,c:),f�ox fil, Dt�cu RCCcivcr,f:� � Pcrmit?� ll—D� ��
�i�.• �," 275q Kcllcy Pttrkwuy
';;� p;�•.''. }'� C:ryslal C{ny.MN 55325 Appravcd[iy; � Anmunt S: � � '
� ..;,c,r,'� Pl��nc(952)249-4GOU fux(�$7.)249.AciIG
t,,,�����,.
CiTY OF ORONO-i��fFCHANTCAL PC�tMIT
(All Connncrciai permi�mu�t bc��ppmvcd lfy thc Buiiding Olhicial or Inspcctur;inrUor�irc Morslisll)
c:�NEtzn.�,.iN:FORMAT.r.ON m�
I, Yo�i may aprly for mcchanical permits Uy mail or in�erson at the City o{ficcs. A.pplic�.Linn�will
bc rc�icwcd�nd e permil will l�e issu�d within two working days.
2, Pcrmit cr�rJs will hc�ent:hy rc�urn mail at'tcr a rcviow is eompleted. PI:T2MfTS�iRE NOT
VAL((�UNTiL YOU RECEIVE A P�RMIT. WORK_M_ ST NOT BEGiN UNTIL T.H�
PTRMIT CARD IS POS�'�n ON TH:r:.,)OB SI'fl:.
3. :M.echac�ical f�esiens Complctc cal�ul�lions,dcf.lil5 end Speciftcp.tipns are required For�1�h.
heating,�ei�filati.on,laumi.dal:ie2.li.on-Jcliumidif�icar.inn,and air condi.tioning insiall�ition incli,iclin�
lieat loss/hcat gain ealcula.tion,de9i.gn 1:emperaturEs,cRuipment ratings and idcnt.ifica4ion as t�
typo,manufaclutcr and mocicl. Uaca sha.11 bc��rescn�cd on form providctl.
4. When any new construction or rcmodclinb i.:�involvCd,fl.s�psarate buildin�rermit must hc
oGtained,
5. All work musl b�done in lccordance with the[fiif�rn�'Mcchanic�tl Codc/Sl��le 6uildin�Co�le
rCqUircment�.
�i. All worl:must be inspcctcd(rotigh-in an<I I.in�l), C:�11 O52)249-4C0(l.
(Z4-481aour nol'icc rchuired)
7. I-louse 1-lcating Tcst Recard must bc submitt�d bclorc kinAl.
� TvnE oF r�r�vrr.T
�c����it n�i Ti��l ��pay)
�Resicl.c��ti�.t ❑Commercial(Approval Rcquircd}
❑ N��u ❑Addi�i.ona] ❑ Repairs �Repl�.ce
Job 5itc/ Owner lnfomia.ti.on;
Sitcn.d.dress, ��P�� /'J��S�-l'�//-�L� 2�
Owncr� ,%Q'1�Y D L�-.XJn/ Mailin.g.A.ddtess: ' ,(��f0 /✓����l1J L--��C.�,
� Cily: _Q/�'_g/tlU 7ip: �����
H.om.e Pl�one: ���i- ��3 �o��aJ� Altcrna.l'e Pltat�e:
Con.tractor inFormatio�i:
C:ontractor: �U�'1 rF�l1/✓%JC.6,�T� Cantact Pc.rson: ��`!Q�/
ff�G
Aciciress: ,��0/ �-�?l'; 5 State i3ond #: �QL/OS Co�lv 9
CitY: �/v�5, 7i.p:�J7TJ�EK.illTclt1011 D1tC: �' f51020/�
Ph�ne: �D/����/- �f08� A.Ilcrnate Phon.c:
[� �nsurancc ,-C:urrent: VU�S j ��/l1�7k� �N'S.
].
10/2012011 08: 27 6127218091 SODERLIN PAGE 03105
, ,
MECHANTCAL Sl'STEMS I3FTNG INSTALLED
Notc:.A.I1 Gcothernial5ystcros will now requirc;x Sicc Plan &Review by our F3uilding Official,
aS THiS C.�F()THERMAL? ❑ Yes (�N�
HF..A�9NCr SYSTL+'MS
Qiaantil.y; �
Makc� ��/1�1 �/,�/ ---�� .. --
Moa�i; J_�r�o �_,._ .
F���: . E,A:S -
�luc Si2e: ... •--•
Input BTUs: /�.0 ODU _ ._ _
Output BTtis; v,..__ ... . _....-.--
C��'M' ,._._.... _, •-•—
COQL].NG SYSTTMS
Quent.itY� .....,......_
Makc.
�iodcl:
TOnti:
T-�.Pnwor
F1.REP1,�iCE5
❑ C.r;�Pactory L'ircpl�cc [3rand Nttimc;
❑ Wood Burniii� f"ircplac�
❑ Wood Stove Modcl No_:
❑ Wood Stovc wilh Fluc/Masonry
V EIVTILATION
❑ No. Kil:ch�n Exhaust ducl rccirculating _ „ ,_clm
❑ �fo, Bath Exha.usl.(,rnusl hBVC dUCt O111:RiCIC� cfm
❑ No. OU,.cr Fans: Locati�ns cfm
TU�L S'.I'ORAGF, (Must he a/rp�•nved hy Tire Marshall if'proposin�fo ahnadnn tA�ak i►�place.)
❑ Installltion ❑ Rem�vzl
Fu.el pil: . , fiallons ❑ Undcr round
g ❑.Insicic ❑Qutsiile
T P Gas: ,_g�llons
Ol:hc.�r:
GAS LIYr ON.LY
❑ fhaccluor. Grill ❑ Qd�cr/List Whai.�C�Whcrc:
2
10/201,2011 08: 27 6127218691 SODERLIN PAGE 04/05
P.ERIvIIT FEE CA.LCULA.TiON(S)
B�SBn OFr - z002 STATE STATUr
❑ Ycs,this sccti�n��Pplies
Thc replacemei�c of a Rcsidcntial .1ixl.ute or ar,Rli;.tnce that mects 1l] lhrcc of lhe foll��wing requircmcnts;
1. Docs not rcquirc modific�tipn to elecu•ical or Sas servicc.
2. 1-las a total cost of$500.00 or Icss;cxcluilinf,t.he cosi.oP�'he Pixture or a��pliance; and
3, Is improv�d,insl.alled pr replaced hy thc homcowner or liccnsed con.lracl•vr.
Slci��ncxc section, if Uiis�pplics; CUsI of PermiC $ 15.00
State SurcliarGe S 5.00
Mail-h�i'ec(Tf Applicab[c) S 2.UU
Total Pcrmit Fee $
PERiv�IT F�L CALCLTLATiON S -JQBS OVE:R$500.00
if abovc docs not apply;follow gui.cicli.nc�bclow:
l, COIYTRACT PRICT *is 1..25"/n o!'conlract pr.icc with a(Minimum Fee of�50.00)
TJ l���� a.0 I 25 $ ���� ��✓'�
(�pmr��cl pri���) [minima�n$50_00)
2. Sl'A'1'I:S[112CI•IAR(;1�. ,U��
x .OQpS $ �,
(conu��ct.�irice) -
3, POSTAGE c�HANDLLNG(Oiily on Mail•in An��licati�n�) $ 2.00
4. '1'OT.AI., P.i;RMi�'FTE(Add Lincs 1-3 /lhave) $
• "' (.:UNTRACT PRIC� or JO$ CnST rnean, thc �ctual or estimated dollo.r nmoun� ch,�r�ul for tl�c
perniittcd work including m�t�ria.l`, ]��Uor,profit,and other fixed eusCs, It is the a�nount to he chsir�;er.l
ro the customcr Cor fhc work done. l f a.i�y mt�.lCr.ial, cquiprnent, lal.�or or inst�llations arc furnished hy
I.lic owncr, [cnlnt or�ny OthCr p��ty, tl�e reasona.hle m�.rltel valuc of such items must tio �iddcd to thc
cstimal.eil cUsf or contract price fpr pern�if Fcc ptnposcs. In t.hc evcnt tl�at there is a di.apulc un thc
an�ount of chc jnb cost, fhc t:ity may requesc fho submission of a si�ned c;vpy oF the acl:ual cnntracL
MECHANTCAL PERMTT APPi ICA7'.CON AGREEMENT
Thc u.ndcrSiSncd hcrel�y appJics to thc City Cor istivancc of 1 Mc:ch;.tnic�[ Pcnnil, �.grecs co do all
work in stricl accorda.ncc witlt �h� ardinanees uf thc City 3nc{ the rC�LIIAlians pf tI1C St3te of
Minncsota, and ccr�iiie� tl�at all sta.tcments madc on this aPplication ��re complcic, truc �nd
corr�cc.
A� licant's Si naturc: D �Q �Q —
1 P � Datc: /�
Reset Form
3
10/2612011 08:27 6127218091 SODERLIN PAGE 05105
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� � � /Q ATE TIME ! /
l �2� /� V
ITY OF ORONO CALLED IN �
INSPECTION NOTICE -�/� SCHEDULED �,CLL. �
PERMIT NO. D� I /�IO`25 �COMPLETED
ADDRESS "�`� ��O ��-k- �I�2
OWNER TELEPHONE NO. ��' ��19����-3
CONTRACTOR ��i--t�-�"1-L�t/�
j; DESCRIPTION ��C � �"" , YL'�1 � — ���-�-'' �" l�C f�'1(kck
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ 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
v ❑ PLUMBING RI ❑ SEP I `FINAL ❑ FOUNDATION/REMOVAL
Z OW�ONTRACTOR TO MEET YOU�YES_NO
� COMMENTS:
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� ❑WORKSATISFACTORY:PROCEED �PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR W4LL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTIONREQUIRED.CALITOARRANGEACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor or}sitei
Inspector. ��`"�o/ �
White Copylinspector's File Canary CopylSite Notice