HomeMy WebLinkAbout2015-00532 (mech) CITY OF ORONO * Z 0 1 5 — 0 0 5 3 2 *
2750 KELLEY PARKWAY DATE ISSUED: OS/04/2015
. ORONO, MN 55356—
952 249-4600 FAX: 952 249-4616
ADDRESS : 3770 BAYSIDE RD
PIN : OS-117-23-24-0121
LEGAL DESC : OTTOVILLE ON LAKE MTKA
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTIOI�1 TYPE : HEATING SYSTEMS
VALUATION : $ 3,228.00
APPLICANT MECHAMCAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.61
CITY VIEW PLUMBING&HEATING
1880 WAYZATA BLVD W TOTAL 51.61
P.O. BOX 150 Payment(s)
LONG LAKE,MN 55356 CHECK 35301 51.61
(952)473-8793
Minnesota State License#: plbg-MB005208
OWNER
STEPHENS, WINFIELD
3770 BAYSIDE RD
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed 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 grant 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 whether or not specified herein.This permit will
expire and become null and void if construction authorized is no[
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any[ime after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance wi[h[he State Building Code.This permit may be
rev�t any time for due cause.
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' ant Permitee Signature Date Issued By Signature Date
_______ --- ___---- --- . .._._.. ..__...._.
_�` FOR CITY L�SE O�Z�'
� Cih•of Oivno z
, �ON` � P.O.Bos 6b Date Received: ���(�Peimrt� l��'"�'�' ✓7
O � �?SOKeIIeyPari.-�vay �,(
�� � CrystilBay,i4[Iv 55323 Appro4rd By: � Amaurt$: �� �
" � �� � Phme(952)2�9-4600 Fax(9i�)�49-4616 /y�Q
1�\I � ) � , ' �j�'J
��`��� �`'/ CITI OF OR010-MECHA�tiICAI.PERl�'IIT ��
\��f.�t{���t� (pllConutrrcialpmnits mist be approved by'the Build'a�Oflicnlor Inspecta az�dor Fia�iarshall,l
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GENERAL INFORMATION
1. 1'ou may appty for inecharvcal pemvts by nn�1 or n person at tl�e Ci[y offices. Applications«��1
be reviewed arxi a pernYit«�ill be isst�ed wiitun hvo�vorkuig days.
3. Pemiit cards�villbe sexu Uy retum n�il a$er a ce�����is con��ted. PERI�4ITS ARE NOT
�'ALID UNTIL 1 OU RECEIVE A PERMIT. «'ORk�IUST NOT BEGIN LT'TIL THE
PERMIT C�RD IS POSTED ON THE JOB SITE.
3. Mechanical Desisns—Coix�letz ca]culatiom.deta�s ar�d specifications are requu•ed for each
heating,��ent�atmn,lnut�if�at�trdetnuiridif�ation,and air coixiiti��installatmti inc�xdir�
t�at]oss/heat gam calctilation,design ten}�esatw�es,eqt�ment ratings and icientific<�tioxi as to
type,matnz6cturer atxi imdel Data shallbe presented on fomi pro��ied.
4. �L'hen any i�e�u conshZu:t�n or renx>del'u�g is ai�lved,a separate building pernvT nnut ve
obtau�ed.
5. All�i�ork irust be done in accordar�ce�a�ith tl�e Uniform Mer.haz�al Code/State Bw7du�g Code
requffei�nts.
6. All��rork rrust be u�spected(inugh-n and fnan. CaII(952)349-4600.
(24-48 hournorice irquiird)
7. House Heat�g Test Record must be subimtted before frial
T'1'PE OF PERMIT
_ �Checl�AIl That Apply)___.__..
-- -- -_____ - --- ----_ __.,_._ .,___.�.._.__.
�Residential ❑Coirnl�ercial(ApprovalRequired)
❑Ne�v ❑Additional ❑Rtpairs ❑Replace
� Job S fe!O�vner Info�nation: (
3� a s �'�.�. ��
S ite Addr�s s: �
O�vner:� �•S G� Y' „� Ma�ling Address: �7� J�t�15����
C�y: �d��nC� Zi�: 5 S J � �
Home Phone: (�I a-��� S 7 3 3 Alten��te Phone:
Contractor Inforn�ation_ ��� � �1
Contractor:
C,,�� U;e� F I b��� I�C� Contact Person: Q�,�v, 1-� �� ���CtY•�
Address_I��B �i We3��10.�2c��"ct�j�v'�1 Stat�Boud#: ����j v1� �
Cty: �rr►�►,c- Lc; l�c� Z�:.�53SC�EYpirltionDate: � � ?�)�
Pl,oIlz: 9s 2-y�3�S7�� Altemate Ptione: 6/e�(��5 �L�IL�
❑ It�surance-Ctirrent: �P__�
1
' MECHANICAL SYSTEMS BEING INSTALLED
._.______.__..�__._.__.__.....,....�....._..____.__.__...----_.____.___�_____ T-----_._______._.____ _
• \ote: AllGeotY�nm1 Systenb will t�o��� reqtm�e a S�e Plan�, Rz���i�by oiu�Bttildit�OfficiaL
IS THIS GEOTHERMAL? ❑ �'es �No
/�
HEATING SYSTEMS
Q,�,��: 2
Make: ►l/ �
Model: 1��S r� ` I ����J�y /� �
Fuel: �q,1 `-7G� �
Fhie Size: 3 I �v �
I�utBTUs: I la--�D(�
Output BTUs: %� �� l�
CFl�1: � �(��_
COOLING SYSTEl�'IS
Quar�t8y:
Ma3:e:
Model_
Torn:
H.Po���er
FIREPL.4CES
❑ GasFactoryFn�eplace BrandName:
❑ �'�'ood Bw�r�n�Firep]ace
❑ ��'ood Stove I�1odelNo.:
❑ �'�'ood Stove with Fhae i A4asoiuy
VENTIL.aTI ON
❑ No. Kitct�nEsha�t duct _recirculatin� cfn
❑ No. Bath Ethaiut(inist ha��e duct outside) cfiu
❑ No. Other Fais: Locatmrn c$n
FUEL STORAGE (Must be approred bY Fire Marsholl if proposi�rg to abanrlon tank in plac�)
❑ Installation ❑ Reit�o�al
FuelOil: galb� ❑ Undergrotmd ❑Irnide ❑Outside
LP Gas: galloi�s
Otlier:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List Vb'Isat&Where:
�
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PER�'��IIT FEE CALCL'LATTON S
�__ BASED OFF -�002 STATE STATUE j
❑ Yes,tivs section applies
'Il�rep]acement of a Residenti��l f'nture or appliance that tneets aIl tlgee of tl�folbwing requi�emeius:
_ _ _.
l. Does not require imdifxation to electricalor gas service.
?. Has a totalco_st ofS500.00 ar kss;�cchuiu�tl�cost ot d�e frcture or appliance:atxl
_ ____
3. Is unproved,�talled or replaced by ilbe hoir�eo�timer or licensed contractor.
Skip r��t section �'tivs applies; Cost ofPemvt $ 15.00
State Surcharge � 5.Q0
1�iailInFee<IfApplicable) $ ?.00
Total Peinut Fee S
_ _. . __ . .. ........ _ __. . _-
� � � W PERNiIT FEE CALCULAT'ION(S)—JOBS OVER$500.00
IfaUo��does rwt apph;follo�ti�guyielines belo�v:
1. CONTRACT PRICE * is 1?59�0 ofconhact price with a(1Vlinimum Fee of S50.00)
3��� ��
Y.O125 S
(conffact}xie) (miniar�m$SO.U(1)
Z. STATE SLRCHARGE
�.0005 �
(c�x,vacc pr c r)
3. POST.4GE�HA�IDLING (Only on Ma�1-In Ap�fications) S._____._____,_�T00
4. TOT�L PERRZIT FEE(Add L'n�es 1-3 Above) S
— * CONTRACT PRICE or JQB COST n�ans the actual or estnnated dollar ai7nar�t charged ior dle
penrritted�votic uxhadi�g ir�aterials,]abor,profit,and other fiYed costs. It is die amow�t to be charged
to the ctuton�r for the wotic doc�. Ifany nzaterial equ�ineiu, labor or uvtallatioiLs are fimaislied by
dle o�i�ner, tenant or any other party, the reasonaUle ix�rket�ah�e �f such itenr irn�st be added t�the
estnnated cost or contra�t�rice for pei7ivT fee pt�oses. In the e�Rnt that there is a dispute ota tl�e
aimutrt of the job cos� the City it�y request the st�crossion of a si�med copy of tlg achaal rnntract.
MEC:HANICAL PERMIT APPLICATION AGREIIvIENT
The tu�dersi�izd hereby applies to tt� City far i�suance of a Mechatucal Pertmt, a��ec� to do all
�vork in strict accordance �v�h the orduti�nces of the Ciry and d� re�il��cions of t��e State of
Mir�nesota, and certifies ttiat all statements tr�ade on thb applicati�n are corr�plete, t�z�e and
con•ect.
Appficant's Signature: �.1 Date: � ! ��! �
3
�-#- t��' T E
��CITY OF ORONO � CALLED IN
INSPECTION NOTICE SCHEDULED 1�� —� S ��4rw
PERMIT NO. 'L��S'��Z COMPLETED
ADDRESS � ���� �a-t�S / oLe 1�
OWNER TELEPHONE N0.�5a- y7�87�I�
CONTRACTOR -��� V�'e � P1�-�-�b
� DESCRIPTION ���'1 ��� � �����'f�.Y�
l� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ ME �ll ❑ SITE INSPECT�ON
Q ❑ FRAMING MECHANI A_L__.�_._ ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUI�T-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
v ❑ DEMO-SITE �- ❑ $�PTIC INSTALL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:1�_YES_NO
� COMMENTS:
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W ❑WORKSATiSFACTORY:PROCEED PROJECTCOMPLEfE
� ❑CORRECT WORK 8 PROCEED SUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WFLL REfURN
❑CITATION ISSUED
❑STOPOROER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours i a . (952� 249-4600
OwnerlContractor on site: `
Inspector.
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