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HomeMy WebLinkAbout2015-00595 - gas line only CITY OF ORONO * 2 0 1 5 - 0 0 S 9 S * ' 2750 KELLEY PARKWAY DATE ISSUED: 05/14/2015 ' ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 763 BRIDGEWATER DR PIN : 33-118-23-12-0091 LEGAL DESC : STONEBAY SEVENTH ADDITION : LOT 4 BLOCK 1 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY VALUATION : $ 1,200.00 NOTE: GAS LINES FOR:2 FIREPLACES, 1 RANGE& 1 DRYER APPLICANT MECHANICAL 50.00 STATE SURCHARGE MECH(VALUATION) 0.60 SCHULTIES PLUMBING TOTAL 50.60 1521 94TH LANE NE Payment(s) BLAINE,MN 55449 CHECK 33285 50.60 (651)786-4007 Minnesota State License#: plbg-058799PM,mech-MB005379 OWNER Wooddale Builders 6117 BLUE CIRCLE DRIVE MINNETONKA,MN 55343- AGREEMENT AND SWORN STATEMENT 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 not grant permission for additional or related work which requires separate permits. 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 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 aze requested in conformance with the 5tate Building Code.This permit may be revoked at any time for due cause. ,�/� �/N� ;d�� S -�y- �s" U�yn-�.�� � l ! l C Applicant ermitee Signature Date Issued By Signature Date FOR CITY USE O1�LY � /� �'� City of Orono ��'� � ��;ti P.O-Box 66 Date Received: Permit# �-.�� ��, 2750 Kelley Parkway � �� Crystal Bay,MN 55323 Approved E3y: AmounY$: Phone(952)249-4600 Fax(952)249-4616 ���n � \����������� 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 RECE[VE A PERMIT. WORK MUST NOT BEGIN UNT[L THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desiens—Complete calculations,details and specifications are required for each heating,ventilation,humidification-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 Uniform Mechanical Code/State Building Code requirements. 6. All wark 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 A I ) �'�Residential ❑Commercial(Approval Required) �New ❑ Additional ❑ Repairs ❑ Replace Job Site 1 Owner Information: Site Address: �' Ownew. � A t,�,�vlailing Address: �o//j ��j , ���,L'll, ��� _—� c—� � City: ,,%�-C-��-z��?� � Zip: ���� `�-- -,�'/�J`�-C��y� � -�� -�� Home Phone: � � �/:5 Alternate Phone: `i� �f��� � Contractor Information: Contractor: .�����/� ��LG'� Contact Person: �� � � ' � Address: /� �� � �- State Bond #: � C��.�7�} City: �-�"-R-' Zip: ���1� Expiration Date: � � � J Phone: ���-7v�'�`- yC�� Alternate Phone: ���'7��'��� ❑ Insurance-Current: 1 ti � ' MECHANICAL SYS'T'E��'����'r TI�tSTALLED 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 Model No.: ❑ Wood Stove with Flue/Masonry VENTILATION ❑ Na Kitchen Exhaust duct recirculating cfm ❑ No. Bath Exhaust(must have duct outside) cfin ❑ No. Other Fans: Locations cfm FU EL STORAGE (Must be approved by Fire�M1larshall if proposing to abandon tank in place.) ❑ [nstallation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill � Other/List What&Where: p<' „2 ��e� 2 ' � � C/ � � PE�Ri�IIT F�E CALC'UI,ATION(S) BASE�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;excludinQ 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 $ 1�`E�`T':��:���►��,�Z�'�"�� . :� .,,.�.� .'��R..���t}':��..,. ;. : . .d: If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) , f � x.0125$ ��. dU (c ntract price) (minimum 550.00) 2. STATE SURCHARGE �l,p�U�� x.0005 $ : �v �(conuact price) 3. POSTAGE&HANDL[NG(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ s�• �p� ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted 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 purposes. 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. 11�ECHA���L�E�MIT AP�'��;�'��1,,�"'',�l���I�ENT ' ' 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 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: / o� 3 � � / .�C�' ' � �Q�S� DATE TIME CITY OF ORO�i"o � 595 CALLED IN �O�.S�� INSPECTION NOTI SCHEDULED 7-d 7-/� .�'� � PERMIT NO. �/ �597 OMPLETED ADDRESS 7 � � OWNER TELE ONE NO lX�3 �����7 CONTRACTOR � �� � DESCRIPTION �� \ � � l� ❑ FOOTING EMO-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 ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERlCONTRACTOR TO MEET YOU:_YES_NO � .f�• � COMMENTS: ��,/S' o��S9T- Pl�. p w v - p�/C G��,�.- a �� G•i 't e� /s ��GQcK� J � P/'Ov�JG 4o�oP.G<o.�sG //�s-C.,S pil ��cl� O _ � S��Q o�F' ����t�4c s�.t,,L.G, - B e��.�r o w�<< 2 c st . l� � W � Q z ao ��- oo�� - �as /,�r�s �'d� F.P r4K e � '� � Blf ' �✓ - rs ���� Gr� � -��� ��e�.� 3� s� , �« � - a6-�� � � �G�oRKSATiSFACTORY:PROCEED O PROJECT COMPLEfE W �O CORRECT YVORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECdVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTO TAKEN INSPECTOR W4LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 2a hours in advance. (952� 249-46�� OwnerlContractor on site: Inspector. � I r'ri- � White Copyllnspector's File Canary CopylSite Notice