HomeMy WebLinkAbout2005-P08826 (mech) � PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: po8826
Crystai Bay, Minnesota 55323 Permit Type: 1vlechanical Permits
(952) 249-4600 Date Issued:
6/13/2005
SITE ADDRESS: 3845 Bayside Rd Unit#
Long Lake, MN 55356
P��� OS-117-23-23-0006
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Mechanical Permits Permit Sub-type(s): Gas Line Inspection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 15.00 valuation: $ 250.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 15.50
APPLICANT: Manatee Plumbing OWNER: John&Sherri Thiesse
11525 199th Circle 3845 Bayside Rd
Silverlake,MN 55381 Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL[MPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLIC PERMITEE SIGNATURE ISSUED BY SIGNATUItE
Copies: 1-File(Signatures Reguired), ]-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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� FOR CITY USE ONLY
,��� City of Orono
O x, O P.O.Box 66 Date Received: Permit#
i,;,;,�_,,, 2750 Kelley Parkway
a '�j�'`_f�;�`i"_ �. Crystal Bay,MN 55323 Approved By: Amount$:
9 Y;��,= �
�^ l��n�.�o (952)249-4600 �
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CITY OF ORONO-MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or[nspector and/or Fire Marsliall)
GENERAL INFORMATION
1. You inay apply for mechanical pernuts by mail or in person at the City offices. Applications will
be reviewed and a permit will be issued�vithin two working days.
2. Peinut cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PEI2MIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical DesiQns—Compiete calculations, details and specifications are required for each
heating, ventilarion,hunudification-dehumidification, and air coilditioning installation includiug
heat loss/heat gain caiculation, design temperatw�es, equipment ratings and identification as to
type,manufacturer and model. Data shall be presented on form provided.
4. ��"rren any new construction or renlodeling is involved, a separate building pernut must be
obtaiued.
5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code
requirements.
6. All work must be iilspected(rough-in and final). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be subinitted before final.
TYPE OF PERMIT
(Check All That A ply)
�Residential ❑ Coinmercial(Approval Required)
❑ New �Additional ❑ Repairs ❑Replace
Job Site/ Owner Information:
Site Address: 3� �-I � ��c� 5�Q-e �U,
Owner: �b�1'C 1���S S� Mailing Address: �wl ~�
City: �;�C���'1 � Zip:
Hoine Phone: l� I Z (u ��d I �'�� Altei7zate Phone: "?� 3 �- �'-{�--- �`t 2 �
Contractor Inforniation:
Contractor: j/�Q;,�c���� ,Q�v�;v� Contact Person: �U� C���
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A d dr e s s: ����z�a I�(�C��l y c��e S ta te Bon d #: 5 ��8�'j Z 5
City: rj ���U�r �c.�]�� Zip:S�8� Expiration Date: � Z� 3�•- O 5
Phone: 3 Z o 3 Z�� v 4 a(c Alternate Phone: �l�- �? 5�o I I��Z
❑ Insurance- Cun-ent: �QG��r c����, 3� �•- �tp
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MECHANICAL SYSTEMS BEING INSTALLED
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES N�
`_� +Gas Factoiy Fireplace
r ❑ Wood Buming Fireplace
� ❑ Wood Stove
❑ Wood Stove With Fiue
Brand Name: Model No.:
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)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
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Other:
GAS LINE ONLY
--- —�-��"'Outdoor Grill �� Other/List What&Where: �� /L���L�`{� �L,
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� PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
� Yes,tltis section applies
The replacement of a Residential fixture or appliance that meets all tl�ree of the following requirements:
1. Does not require modification to elech�ical 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 conh�actor.
Skip next section,if this applies; Cost of Pernut $ 15.00
State Surcharge $ .50
Mail-Ii1 Fee(If Applicable) $ 1.50
Total Permit Fee $ 1 ?. o�
PERIVIIT FEE CALCULATION(S)—JOBS OVER $500.00
If above does not apply; follow guidelines below:
1. CONTRACT PRICE * is 1.25%of conn-act price with a(Minimum Fee of$35.00)
�-�5��.. �L� x.o125 $
(contract price) (minimum$3�.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x.0005 $
(conu�act price) (minimum$ .50)
3. POSTAGE&HANDLING (Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
■ * COI�TTRACT PRICE or JOB COST means the achial or estimated dollar amount charged for the
perniitted work including materials, labor, profit, and other fixed costs. It is the amount to be charged
to the customer for the work done. If any material, equipinent, labor or installations are furnished by
the owner, tenant or any other party, the reasonable market value of sucii items must be added to the
estimated cost or contract price for pernut fee puiposes. 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 conh�act.
■ ** The STATE SURCHARGE is .0005 of tl�e Building Department at(952)249-4600 for the price.
MECHANICAL PERMIT APPLICATION AGREEMENT
The undersigned hereby applies to the City for issuance of a Mechanical Pern�it, agrees to do all
wark in strict aecardance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements inade on this application are complete, true and
correct.
Applicant's Signature: _ Date: �� � (�0 �
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