HomeMy WebLinkAbout2011-0054 - mechanical * ' CITY OF ORONO PERMIT NO.: 2011-00541
` 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE IssuEn: 06/28/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 766 BRIDGEWATER DR
PIN : 33-118-23-11-0109
LEGAL DESC : STONEBAY FOURTH ADDITION
: LOT 014 BLOCK 001
PERMIT TYPE : MECHAN[CAL(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : GAS LINE ONLY
NOTE: REPLACE GAS DRYER,FLEX LING&DRIP LEG
APPLICANT MECHANICAL(<$S00) 15.00
CENTER POINT ENERGY MINNEGASCO STATE SURCHARGE MECH(<$500) 5.00
9320 EVERGREEN BLVD NW
SUITE B MAIL-IN FEE 2.00
COON RAPIDS, MN 55433 MISC FEE 0.00
(�63>�s�-6zoz TOTaL zz.00
OWNER
PETERSON, LEE& DARLENE
766 BR[DGEWATER DR
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time atter work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due-eause.
`�iyt�Q'� �i11, � � ��� l l
Applicant Permitee Signature Date Issued By i nature ate
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
� '
FOR CITI'C�SE O\Ll'
��� City of Crono
,rO �, P O Box 66 Date Received: Permit#
27�0 Kellev ParkN�av
a ' � ' Crystal Bap,NIN����3 Approved Br. Amount$
" '�� •o, Phone(9�=)249-d600 Fax(9�3)249-4516
�
x,.ssoy`>
CITY OF ORONO—MECHANICAL PER�VIIT
(All Commercial permits must be approved b��tl�e Buildine OTficial or Inspector and,�or Fire Nfarshall)
GENERAL IIv`�'ORMATION
1. You may apply for mechanical permits by mail or in person at the City oifices. 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. PERNIITS ARE NOT
V.qLID UNTIL YOU RECEIVE A PERi�1IT. �VORK NIUST NOT BEGIN t�'��TIL THE
PER�'ITT CARD IS POSTED ON THE JOB SITE.
3. ��Iechanical DesiQns—Complete calculations, details and specifications are required for each
heatinQ,ventilation,humidification-dehumidification,and air conditionin� installation including
heat loss/heat�ain calculation,desiQn temperatures,equipment ratings and identification as to
rype,manufactur•er 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 witli the Uniform Mechanical Code,iState Buildin�Code
requirements. �
6. All work must be inspected(rouQh-in and final). Call (95?)249-4600.
(2�-43 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 ❑ Additional ❑ Repairs ❑ Replace
Job Site / Owner Inforrllation:
Site Address: �1�c'�r � E ��C?� ��- �'�'
Owner: �—`` � �����° �-'��l Mailin� Address: "1<<-(<- �a- ,c,�'�.��=E'r �+�
c�Ty: C� c•���_, zip: �� �, ���c,-
Home Phone: �`�� ' ��`� � ' ��'��' Alternate Phone:
Contractor Information:
Contractor: CENTERPOINT ENERGY Contact Person: JOANN ZINKEN
Address: 9320 EVERGREEN BLVD NW State Bond #: 22013346
SUITE B
City: COON RAPIDS Zip: 55433 Expiration Date: f]R/90J2011
Phone: 763-757-6202 Alternate Phone:
� IriSut'3riCe—CUI'T'erit: Travelers Indemnity Company
1 Workers Compensation&Employers Liability
Policy#TQK-UB_9349B101
Policy Period 01/O1/2011-O1/O1/2012
� !
MECHANICAL SYSTEMS BEII�TG P�STALLED
Note: All Geothermal Systeins will now require a Site Plan�Review by our BLiildinQ Official.
IS'�HIS GEOTHERtV1AL? ❑ Yes �No
HEATING SYSTENIS
Quantity:
Niake:
Model:
Fuel:
Flue Size:
Input BTUs: _
Output BTUs:
CFI�I:
COOLING SYSTENIS
Quantity:
Make:
?vlodel:
Tons:
H.Power
FIREPL.4CES
Gas Factory Fireplace Brand Name:
Wood Burning Fireplace
Wood Stove Model No.:
Wood Stove With Flue
VE�'TILATION
No. Kitchen EYhaust duct recirculating cfm
No. Bath Exhaust(must have duct outside) cfm
No. Other Fans: Locations cfm
FUEL STORaGE (�Ytust be approved by Fire�tilarshall if proposing to abando�i tank in p[ace.)
� Installation � Removal
Fuel Oil: �allons ❑ Underground ❑ Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
� Outdoor Grill ❑ Other/List What&Where:
2
PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
�Yes,this section applies
The replacement of a Residential fixture or anpliance that meets all three of the followina requirements:
l. Does not require modification to electrical or gas service.
?. Has a total cost of��00.00 or less; excludine the cost of the fiYture 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
� ����� (1_�j ���`,��,, ��� State SurcharQe $ �.00
� ��p lCx�-
�� � J � Mail-In Fee(If Applicable) � �— -_.OD�— t
- Total Permit Fee �� � ' :� CY'�`
�'��-� �;r�t �L, �a ���=,� �{-�� . �_ �- �� � �
�PERMIT FEE CALCULATION(S)-JOBS OVER $500.00
[f above does not apply; follow suidelines belo��•:
1. C�NTR4CT PRICE * is 1.2�%of contract price with a(n�iinirnum Fee of��0.00)
x.0125 $
(contract price) (minimum$50.00)
2. STATE SL�RCHAR�GE �* Add the State Bld�Code Div. Surchar�e(.vlinimum Fe:of�5.00)
x.000� $
(contract price) (minimum$�00) �
3. POSTAGE&HANDLING (Only on Nlail-In Applications) $ 3.00
4. TOTAL PERNIIT FEE(AddLines 1-� Above) �
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount char�ed for the
permitted work includin�materials, labor, profit, and other fiYed costs. It is the amount to be char�ed
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 perniit 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 cor.tract.
■ ** The STATE SURCHARGE is .0005 times the Contract Price or a minimum of�5.00.
MECHANICAL PERMIT APPLICATION AGREEMENT
The undersi�ned hereby applies to the City for issuance of a Mechanical Permit, a�rees 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. '�
/� (�� � �'
Applicant's Si�nature: ��2.-�YL� ���1� Date: �'�� ��
O
�
Reset Form "� ^
�