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Home My WebLink About2011-00564 CITY OF OR NO PERMIT NO.: 2011-00564 ' 2750 KELLEY PA WAY ORONO, MN 55 56- DATE ISSUED: 06/30/2011 952 249-4600 FAX: 9 2 249-4616 ADDRESS : 4355 BAYSIDE RD PIN : 06-117-23-12-0007 LEGAL DESC : LTNPLATTED 06 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTIOI�1 TYPE : FIREPLACE-GAS VALUATIOI�I : $ 2,250.00 NOTE: GAS FACTORY FIREPLACE APPLICANT MECHANI AL 50.00 MITTELSTAEDT INC P O BOX 454 STATE SU CHARGE MECH (VALUATION) 1.13 WATERTOWN, MN 55388- TOTAL 51.13 (612)716-9595 , Minnesota State License#: 20012394 OWNER WHITE, GREG&LYNN , 4355 BAYSIDE RD MAPLE PLAIN, MN 55359- � AGREEMENT AND SWORN STATEMENT I 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 I not grant permission for additional or rela[ed work which requires separa[e permi[s. AIl provisions of laws and ordinances governing[his type of work � shall be compied with whether or no[specified herein.This permit will � expire and become null and void if construction authorized is not I commenced within 180 days of the date of issuance,or if construction is i suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in Co�rfOrin�nce wrth State Building Code.This permit may be revoke "any tirrie� se. �� i - -,� �� l Appl-�c�f, a�inite�Si ature Date Issu B Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHE THAN DESCRIBED ABOVE. � � F R Cl Y USE ONLY �,►+ City of Orono �Q / �Q O4 `YO� P•O.Box 66 Date ReceiF✓ Permit#�D`�+ �T � ` �,;.,,.a I 2750 Kelley Parkway � a i�` �� Crystal Bay,MN 55323 Approved By: Amount$: � � ��;�4�; � ��,�t��$�v Phone(952)249-4600 Fax(952)249-4616 sexo CITY OF ORONO -MECH NICAL PERMIT (All Commercial permits must be approved by tl�e Building fficial or Inspector and/or Fire Marshall) GENERAL INFORMATION 1. You may apply for mechanical permits by mail or in erson at the City offices. Applications will be reviewed and a permit will be issued within two orking days. 2. Permit cards will be sent by return mail after a revie is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WO MUST NOT BEGIN UN'TIL THE PERMIT CARD IS POSTED ON THE JOB STT . 3. Mechanical Designs—Complete calculations, details and specificarions are required for each heating, ventilation, humidification-dehumidification and air conditioning installarion including heat loss/heat gain calcularion, design temperatu�res, quipment ratings and identification as to type,manufacturer and model. Data shall be present d on form provided. 4. When any new construcrion or remodeling is involve , a separate building permit must be obtained. 5. All work must be done in accordance with the Unifo Mechanical Code/State Building Code requirements. 6. All work must be inspected(rough-in and final). Cal (952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before final. TYPE OF PE IT �� (Check All That A ply) � -�] Residential ❑ Commercial(Approval Required) ❑ New ❑Additional ❑ Rep irs ❑ Replace Job Site/ Owner Infornlation: Site Address: k � � � ° G Owner:� I'C� ��it �f"� Mailing Address: �� -t- C City: ��/'� G� � Zip: 4 �� Home Phone: ,/,�1- �/6- �S' I s Alterna Phone: Contractor Information: �� Contractor: �1-1-tc�5 r"a.e0`f�µ-�• Contact erson: �� r'�C(S'�-fl�� Address: �� 6�c �� Stat�B d#: City: �/`��'�ra-^-� Zip:�3��Expirati n Date: Phone: �P �.� � 7�� ` `I S �/� Alte�-nat Phone: ❑ Insuranc - Current: 1 ' i � f� MECHANICAL SYSTEMS BEING INSTALLED • Note; All Geothermal Systems will now require a Site Plan&Review by our Building Official. IS TffiS GEOTHERMAL? ❑ Yes ❑ No HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: Input BTUs: Output BTUs: CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: H. Power FIREPLACES ,Z� Gas Factory Fireplace Brand Name: �la E-� 6�d c,r/ ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTILATION ❑ No. Kitchen E�aust duct recirculating cfm ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (Must be approned by Fire Marsha[l if proposing to abandon tank in place.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List What&Where: 2 / 1 PERMIT FEE CALCULA .ION(S) BASED OFF - 2002 STAT STATUE �I ❑ Yes,this section applies The replacement of a Residential fixture or appliance that rraeets ll three of the following requirements: 1. Does not require modificarion to electrical or gas s rvice. 2. Has a tota] cost of$500.00 or less; excludin�the c st of the fixture or appliance: and 3. Is improved, installed or replaced by the homeown r or licensed contractor. Skip next section, if this applies; Cost of Pe 't $ 1�.00 State Surc arge $ 5.00 Mail-In Fe (If Applicable) $ 2.00 Total Per it Fee � �- PERMIT FEE CALCULATION(S) —T BS OVER $500.00 ,j If above does not apply;follo�� ffuidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) �� x.0125 $ (contr tpr�ce) (minimum$50.00) 2. STATE SURCHARGE x.0005 $ (contract p ice) 3. POSTAGE&HANDLING(Only on Mail-In Applic tio�s) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) � ■ * CONTRACT PRICE ar 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 an�ount to be charged to the customer for the wark done. If any material, equipm nt, 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 esrimated cost or contract price for permit fee purposes. I the event that there is a dispute on the amount of the job cost, the City may request the submissio of a signed copy of the actual contract. <`' MECHANICAL;PERIVIIT APP�,TCAT ON 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 Cit and the regulations of the State of Minnesota, and certifies that all statements made on thi application are complete, true and correct. T ,/ �� ''"��j,�'" !�.;. �,;... �.-; � � � ,' _ Applicant's Signature:�� -<��,� �� Date: � �� /�� ,� l i 3 i D/ATE TIME � CITY OF ORONO c ALLE IN �rG �� INSPECTION NOTI E ' /SCHED LED 7-6�-�/ � � PERMIT N0.aBL -"�S 7"COMPLETED ADDRESS SS /�-�' OWNER TELEP ONE NO.�12 - 7�� g5�� CONTRACTOR �� "� >; DESCRIPTION �� —�� l� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � O ❑ FRAMING ❑ MECHANICAL FIN L ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FI EPL CE ❑ 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 � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Q OWNER/CONTRACTOH TO MEET YOU:_YES_N v�, COMMENTS: C�- � � �� W C � J � I � O � W � Q � Z W � W � � GW ,�1�VORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑ C�RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN H URS. , � pHOTOTAKEN INSPECTOR WILL RETURN i ❑STOP ORDER POSTED.CALL INSPECTOR ' �CITATION ISSUED ❑ INSPECTION REOUIRED.CALLTO ARRANGE ACC SS. I Cali for the next inspection 24 hours i advance. (J52� 249-4600 OwnerlContractor on site: � Inspector. White Copyllnspector's File Canary CopylSite Notice