HomeMy WebLinkAbout2011-00563 - mechanical CITY OF ORONO PERMIT NO.: 2011-00563
' 2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE IssuED: 06/30/20ll
952 249-4600 FAX: 952 249-4616
ADDRESS : 1261 BR[AR ST
PIN : 10-117-23-31-0042
LEGAL DESC : CRYSTAL BAY MINNETONKA
: LOT 000 BLOCK 003
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : COOLING SYSTEMS
VALUATION : $ 2,500.00
APPLICANT MECHANICAL 50.00
LEGACY MECH SERVICES STATE SURCHARGE MECH (VALUATION) 1.25
223 SANDBERG RD TOTAL 51.25
MONTICELLO, MN 55362-
(763)219-8978
OWNER
PRINTUP, GARY& LINDA
P.O. BOX 104
CRYSTAL BAY, MN 5532�
AGREEMENT AND SWORN STATEMENT
I he work for which this permi[is issucd 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
pennits. 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 not
commenced within l80 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 conformance with the State Building Code.This permit may be ���
rev ed at ny tim for du us . �
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Applicant Permitee Sig ure Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
, FOR CITY USE ONLY
0��� Cit��of Orono
' �O;:, Q P.O.Box 66 Date Received: Permit#
� 2750 Kelley Parkway
i a �14 �z��' �. Gystal Bay,MN 55323 Approved By: Arnount$:
i
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CITY OF ORONO —MECHANICAL PERMIT
(All Commercial permits 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 RECENE A PERMIT. WORK ML�ST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desi�ns—Complete calculations, details and specifications are required for each
heating, ventilation, humidifica�ion-dehumidification,and air conditioning installation including
heat loss/heat gain calculation, design 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 building permit must be
obtained.
5. All work must be done in accordance with the Unifom7 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 submitted before final.
TYPE OF PERMIT
(Check All That Apply)
�Residential ❑ Commercial (Approval Required)
❑ New ❑ Additionai ❑ Repairs [i Replace
Job Site/ Owner Information:
Site Address: /Z 6� ,��-r`,rr- �r'
/�
Owner: Cr.9-7t� �rr'�ru,� Mailing Address: ,�,¢r, ti.
.
City: �ro,Vt , /`1.v Zip: �f3j'/
Home Phone: Alternate Phone:
Contractor Infonnatioi�:
Contractor° .Z�'t,�}c< /�/�r�s,�,`�s�-.�-c'��f�Contact Person: ���r-� ���
T /
Address: �23 ._5.�,�„(l�r�r It�� State Bond#: �j'1��,��Jyt?
City: /`7�iY�'7�tf�/d Zip: fS3E 2 Expiration Date: 3•l y "��
Phone: �L �'-�i1"8���' Alternate Phone: C/Z- /�'7�'�'O7f`
❑ Insurance— Current:
1
MECHANICAL SYSTEMS BElNG INSTALLED '� �� �� ,��
Note: All Geothermal Sys�ems 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: �vv /
Model: f��/�J�Jrj 3d.r/,Z
Tons: ?� �
H. Power
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
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 Mars/:all 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:
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� T'E�RIVIIT�FEE CALCULATIOI�(S) �
� BASED OFF - 2002 STATE STATUE � i
❑ 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; excludin�the cost of the fixture or appliance: and
3. Is improved, installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
� PERMIT FEE-CA�CLJLATION(S)'=JOBS OVER$500,00
If above does not apply;follow guidelines below:
1. CO1�`TRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
v
��� �� x .0125 $
(contract price) (minimum$50.00)
2. STATE Si1RCHARGE Zs���vi
x.0005 $
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) �
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
pernutted 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, equipment, 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
estimated cost or contract price for permit 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 contract.
� MECHANICAL PERMIT APPLICATION AGREEMENT
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
work in stnct accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made on this application are complete, true and
correct.
( J `-� ,-, �
Applicant's Signature:' � Date: ��� 3� O
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