The URL can be used to link to this page

Home My WebLink About2012-01265 - gas line only CITY OF ORONO * Z 0 1 2 - 0 1 Z 6 5 * 2750 KELLEY PARKWAY DATE ISSUED: 12/20/2012 ` � ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1250 BRIAR ST PIIV : 10-117-23-31-0039 LEGAL DESC : CRYSTAL BAY M[NNETONKA : LOT 000 BLOCK 002 PERMIT TYPE : MECHAN[CAL(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY NOTE: [NSTALL GAS STOVE, RUN GAS LINE,REPLACE COPPER,FLGX LINE AND ANTI-TIP 13RACKET APPWCANT MECHAN[CAL(<$500) 15.00 CENTER POINT ENERGY MINNEGASCO STATE SURCHARGE MECH (<$500) 5.00 9320 EVERGREEN BLVD NW SU[TE B MAIL-IN FEE 2.00 COON RAPIDS, MN 55433 MISC FEE 0.00 ��6��s�-62o2 TOTAL 22.00 OWNER PEARSON, LAURIE 1250 BRIAR ST WAYZATA, MN 55391- AGREEMENT AND SWORIV STATEMENT The work for which this permit is issucd shall be performcd according to thc approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work describcd and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this typc of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are reques[ed in conformance with�he State Building Codc.This permit may be revoked at any time for due cause. i�%�Q-� � � � � � Applicant Permitee Signature Date Issued By gnature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED OVE. . *�✓L� FOR CITY liSE OrLY •� �r�""0-'�� City of Orono �� /' 4 � �� P.O.Box 66 Date Recei�ed: Permit# � �� ,� �.'� 27�0 Keliey Pazkway ��,/ ta a{�x F�,� 'Cq•stal Bay,MN i5323 Approved By: Amount$: ��9� �k jt .}`o`�' Phone(95'_)249-4600 Fax(9�2)249-4616 ��or./ `\==ri CITY OF ORONO—MECHANICAL PERMIT (All Commercial pzrmits must be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL INFORMATION 1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PER�4IT. WORK NIUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical DesiQns—Complete calculations, details and specifications are required for each heatina,ventilation,humidification-dehumidification,and air conditionine installation including heat loss/heat eain ca(culation,desi�n temperatures,equipment ratings and identification as to type,manufacturer and model. Data shall be presented on form provided. 4. When any new construction or remodeling is involved,a separate buildin�permit must be obtained. 5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code requirements. 6. All work must be inspected(rough-in and final). Call(952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submired before final. TYPE OF PERMIT (Check All That A lv) [11�Residential ❑ Commercial (Approval Required) ❑ New ❑ Additional ❑ Repairs ❑ Replace Job Site /Owner Information: Site Address: p� oZ`� � ��" � �a� �j� a Owner: ��+�.�� C' E�c�(�`.�G 1'��<<`��l�nMailing Address: �zS�% �Jr�� Y' S� i..�:�--�2 c�;�ct--; ti`Y1'E..� City: C�ra�-� C Zip: �53�1 Home Phone: �5 a'�� 3- b 3�� Alternate Phone: Contractor Information: CENTERPOINT ENERGY JOANN ZINKEN Contractor: Contact Person: 9320 EVERGREEN BL STE 8 2201 3346 Address: State Bond#: COON RAPIDS 55433 08/20/12 City: Zip: Expiration Date: Phone: �763� 7H5-54O4 Alternate Phone: Travelers indemnity Company Workers Compensation&Employers Liability ❑ IriSUrariCe—CUT'Pent: Policy#TC2K-UB_93498101 1 Policy Period 01/O1/2012-01/O1/2013 . MECHANICAL SYSTEMS BEING INSTALLED ' Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. IS THIS 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 ❑ Gas Factory Fireplace Brand Name: ❑ Wood Burning Fireplace ❑ Wood Stove Iviodel No.: ❑ Wood Stove with Flue/Masonry VENTILATTON ❑ No. Kitchen E�haust duct recirculating cfm ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (_�Ylust be npproved by Fire Marshall 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 V✓hat& Where: 2 a PERMIT FEE CALCULATION(S) BASED OFF -2002 STATE STATUE [� Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less;ercludins the cost of the fixture or appliance: and 3. Is improved,installed or replaced by the homeo�vner or licensed contractor. Skip next section, if this applies; Cost of Permit $ 15.00 � � 1,�5�c�.l\ �_S �c��._ `��.n C��S State Surchar�e $ 5.00 Mail-In Fee(If Applicable) $ 2.00 `��r��,r E(��c�C e C°p�3 F�� l eX �` �� C�-v� Total Permit Fee �,�`�(.� �'5-b"�� — . h�C;C'K�'�'_ PERMIT FEE CALCIJLATION(S —JOBS OVER $500.00 If above does not apply; follow guidelines below: 1. CONTRACT PRICE * is 1.2�%of contract price with a(Minimum Fee of��0.00) x .0125 $ (contract price) (minimum 5�0.00) 2. STATE SURCHARGE x .0005 $ (contract price) 3. POSTAGE&HANDLP�IG(Only on iv1ai1-In Applications) � 2.00 4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) $ ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charQed for the permitted work including materials, labor, profit, and other fixed costs. It is the amount to be char�ed to the customer for the work done. If any material, equipment, labor or installations are fum:shed by the owner, tenant or any other party, the reasonable market value of such items must be added to the estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may request the submission of a si�ned copy of the actual contract. MECHANICAL PERMIT APPLICATION AGREEMENT The undersi�ned hereby applies to the City for issuance of a Mechanical Permit, aarees to do all work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies t t all statements made on this application are complete, true and correct. i Applicant's Signature: � Date: 1 �L �f��-- � Reset Form ��,�� , 3 GAS WORK ORDER 1082 Payne Ave. STANDARD 410 W. Lake St. St. Paul, MN 55101 Minneapolis, MN 55408 651/772-2449 b H EAT i N G � 612/824-2656 & AIR CONDITIONING A Blue Do�` Service Co. EQUIPMENT INFORMATION LAST , . FIRST TYPE ADDRESS MAKE CITY ZIP MODEL HM PH WK PH SERIAL TECH DATE INPUT ORSAT TEST RECORD CO2 "::`''� ' �� `;` % METEREDINPUT Cfh CHIMNEYTYPE �<_�'`,C1':.''i 02 ,.={'"r % LIMIT SETTING � ° FLUE SIZE in. CO % PILOT OUTAGE l,�'�� sec CONNECTOR SIZE ' in. NET STACK TEMP � TOTAL CHIMNEY INPUT btuh �� DATE TIME J CITY OF ORONO CALLED IN INSPECTION NOTICE / SCHEDULED /-�f-l3 /�J.'U"D PERMIT NO. l�Z�D/Z'"''�COMPLETED ADDRESS �a5d �- �� OWNER ��'�� LEPHONE NO. �� 3 03Z� CONTRACTOR j; DESCRIPTION '��'�`'�/ /""� """�i L- � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q O POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WEfLANDS 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 v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ P�UMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W � � d .l� � W ❑WORK SATISFACTORY:PROCEED i�e}-+�ROJECT COMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cali for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor n site: Inspector. � � - White Copyllnspector's File Canary CopylSite Notice