HomeMy WebLinkAbout2015-00772 - mechanical , , CITY OF ORONO * z 0 1 5 - 0 0 7 7 z *
2750 KELLEY PARKWAY DATE ISSUED: 06/16/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 1291 BRIAR ST
PIN : 10-117-23-31-0043
LEGAL DESC : CRYSTAL BAY M[NNETONKA
: LOT 000 BLOCK 003
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 450.00
NOTE: ADDING(2)SUPPLY'S AND(1)BATH FAN VENT ONLY
APPWCANT MECHAN[CAL 50.00
STATE SURCHARGE MECH(VALUATION) 0.22
LEGEND SERVICES, INC
201 N MEDINA ST TOTAL 50.22
P O BOX 382 Payment(s)
LORETTO, MN 55357- CREDIT CARD 1282 50.22
(763)479-5002
Minnesota State License#: mech-MB005090
OWNER
KELLETT, KEVIN CURLEY& W
P.O. BOX 41
CRYSTAL BAY, MN 55323-
AGREEMENT AND SWORN STATEMENT
The work for which[his permi[is issued shall be performed according[o
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 goveming 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 not
commenced within 180 days of[he date of issuance,or if construction is
suspended for a period of 180 days a[any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
L J � �,-C'�So � , ��, /s
Applicant Permitee Signature Date Issue y Signature Date
Jun 151503:12p Legend Services Inc 763-479-6003 p.2
. . � �
F CI US�OhLY
City of Orono �j -� 7�
�O�O P.O.Box 66 Date Rec c�Te :� �� Permit#�
2750 KeUey Parkway �y� -� )
r � Crysial Hay,MN 55323 Approved By Amount$: .JC/, d'�
` Phonc(952)249-1600 Fa�t(952)249-4616
\ti�1 � '
�.`' CITY OF OR01�10—MECIIANICAL PERMIT
t�KF�� (All Commercial permiis m�t be approved by the Building Official or lnspector andlor Fire Marshall)
GE�IERAL 1NFORMATtON
1. You may apply for mechanicaJ permits by maif or in person a[the City offices. Applications will
be reviewed and a permit wiEl be issued within two working days.
2. Permit cards wiil be sent hy return mait aRer a review is compleied. PERIVSITS ARE NOT
VAL1D lJNTIL YOU RECETVE A PERMIT. W'ORK N1UST NOT BEGIN UNTIL THE
PER:�11T CARD IS PDS"C'�D ON THE JOB 5ITE.
3. I�4echanical Desitms—Complete calculations,details and specif cations are required for zac4�
heatin�,ventiiation,humidification-dehumidif caEion,and air conditioning installation including
heat loss,iheat gain calculation,design temperatures,equipment ratings and identification as to
type,manufacturer and model. Data shall be prese�ted on form provided.
4. When any new construetion or remotleling is involved,a separate building permit must be
obtained.
5, Afl work must be dane in accordance with the Uniform i�fechanical CodelState Building Code
requirements.
6. All work must be inspected(rough-in and fmal). Call(952)249-4600.
(24-48 hour notice required)
7. l�ouse I leating T�st Record must be submitted before final.
TYPE OF PERIvIIT �
� �Check All That Apply)
Residertia] ❑Commercial(Approval Required)
❑New Q'�dditional ❑Repairs ❑ Replace
Job Site/Owner Information:
Site Address: � ��' ) �k I�-R S�
Owner: �ak� ��-v'N b= Mailing Address: S�'"'` ''�'S ���`�-
City: s,rwc_ Zip:
Home Phone: � Alternate Ahone:
Contractor Information:
Contractor: �_aqc.x� �tn�sS �� Contact Person: !"y'��
Address: 1� ��9x 38�. State Bond #: �,Q�✓�- ��D
City: �-0�'t � Zip:�53s� Expiration Date: �D"�� .�U 1�
Phone: �4.3'�?g".�DO� AIternate Phone:
ytS
❑ Insurance—Current: A��-D��
1
Jun 151503:12p Legend Services Inc 763-479-6003 p.3
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MECHANICAL SYSTEMS BEING I�ISTALLED
Note: All Geotherma4 Systems will now require a Site P(an&Review by our Building�fficial.
IS THIS GEOTHER'�IAL:' ❑Yes �,No
HEATNIG SXSTEMS
Quantity: __
Make:
Model:
Fuel:
Fltte Size:
lnput BTLTs:
Output 8`TL'�s _
CFM:
COOLING SXSTEMS
Quantity: --
Make:
h7odel:
Tons�
N.Power
FIREPLACES
❑ Gas Factory Ficeplace Brand Name:
❑ VVood Burning Fireplace
❑ Vb'ood Stove Model No.:
--___ ___._._._
� W'ood Stove with Flue i Masonry
�'ENTILATION . rgd�v� I� Se�l.`�s 'f' � �7''►"N^ .� �l'A�r 0�.�
❑ Na Kitchen Exhaust duct recirculating cfrn
[�]' Na. __�_ Bath Exhaust(must have duct outside) �t�7 o''�Y cfm
❑ 1Vo. 4ther Fans: Locations cfm
FU EL ST'ORAGE (Must be approved by Fire Marsliall if proposing to ab�t�tdon tank in place.)
❑ Installation ❑ Removal
• Fuel Oil: gallons ❑ Underground ❑inside ❑Qutside
LP Gas: �allor�s
Other:
CAS LI]�E O[YLY
❑ Outdoor Gril I ❑ Other/List What&Where:
2
Jun 15 15 03:12p Legend Services Inc 763-479-6003 p.4
� .
PERMI'f F£�CALCL�LATION(S)
j BASED OFF-2002 STATE STATUE
[�; Yes,this section appiies
'I'he repiacement of a Residential fixture or appliance that meets all three of the foliowing requirements:
1. Does not require modification to electricai or gas service.
2. Has a total cost of$500.00 or less;excludin�the cost of the fixture or appliance:and
3. ls improved,instatEed or replaced by the homcowncr or licensed contractor.
Skip next section, if this applies; Cost of Permit $ E 5.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
PERMIT FEE CALCULATION S)—JOBS OWER$500.00
If above does not apply;fallow guidelines below:
l. CONTRACT PRICE * is 1.25%of contract price with a{Atinimum Fee of$SO.UI?)
� `�SO �.a�2s $ �a, vo
(cantract pricc) (minimum SS0.00)
2. STATE SURCF[AIiGE y�!l
V x.00QS $ • ��
(contract pnce)
3. POST.AGE&HANDLING(Only on Mail-ln Applications) $ 2.�0
��
4. TOTA1,PERMITFF,F,(Add I,ines 1-3 Above) $ �a�
� * CONTRACT PR[CE or JOB COST means the actual or estimated dollar amount cha bed for the
permitted work incliiding rnater�als,labor,profit,and other fixed costs. It is the amount to be charaed
to the customer for the work done. If any material, equipment,labor or installations ace furnished by
the owner, tenant or any other party,tF�e reasonable market value of such items m�st be added to ihe
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 Ciry may requesi the submission of a signed copy of the actuat contract.
Iv�ECHANICAL PERMIT APPLiCATION AGREEMENT
The undersigned hereby appiies to the City for issuance of a Mechanical Permit, agrees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all slalem��ts made on tliis application are complete, t►-ue and
correct.
Applicant's 5ignature: �� ��cr�d+�'-G( Date: �P ���'��
3
�, � � /,
� � DATE TIME �/
�j��CITY OF ORONO CALLED IN��
� � INSPECTION IC /�,J�`) SCHEDULED ��
PERMiT NO `��-' �COMP ED ����
ADDRESS j�� � /✓Y�CP �r '
OWNER TELEP O NO.
CONTRACTOR �
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� DESCRIPTION
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
v ❑ DEMO-SITE ❑�PTIC INSTALL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTORTO�MEETYOU: YES_NO
� COMMENTS:
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W �WORKSATISFACTORY:PROCEED ❑PROJECTCOMPLEfE
� CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CAIL FOR REtNSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 h rs in advance. (95 ) 249-4600
OwnerfContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
�� V
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N TICE SCHEDULED �" 1 )''�
PERMIT NO. ��S-d���ceMPLETED
ADDRESS �� �� �'�t�-�' ��
OWNER TELEPHONE NO���-��-�Z--
CONTRACTOR C�' ��'�
� DESCRIPTION I��, � �c��-_ �o�
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING MECHANICAI FI— NA�' ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
c�.� COMMENTS:
� l�uor!� C ►,�c l � �w�.� �`'�0�613 - Gt�77
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W ❑WORK SATISFACTORY:PROCEED PROJECT COMPLEfE
❑CORRECT WORK 8 PROCEED O ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE CWERINCa PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WlLL REfURN
❑CITATION ISSUED
STOP ORDER POSTED.CALL INSPECTOR
NSPECTION REQUIRED_CALL TO ARRANGE ACCESS.
Call f " spection 24 hours in advance. (952� 249-460�
OwnerlC ntractor on site:
Inspector. ��--
White Copyllnspector's File Canary CopylSite Notice