HomeMy WebLinkAbout2008-00394 - mechanical � , CITY OF ORONO PERMIT NO.: 2008-00394
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE 1sSUEn: 1U24/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 795 BRIDGEWATER DR
PIN : 33-118-23-12-0020
LEGAL DESC : STONEBAY FOURTH ADDITION
: LOT 009 BLOCK 001
PERMIT TYPE : MECHANICAL(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : GAS LINE ONLY
NOTE: GAS LINE TO GAS GRILL
APPLICANT MECHANICAL(<$500) 15.00
FLARE HEATING&AIR COND STATE SURCHARGE MECH(<$500) 0.50
9303 PLYMOUTH AVE N-#104
GOLDEN VALLEY, MN 55427 TOTAL 15.50
(763)542-1166
OWNER
O.T. Development, LLC
LLC, O.T. DEVELOPMENT,
2670 KELLEY PKWY
ORONO, MN 55356-
AGREEMENT A1vD 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. Aii 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 cons[ruction 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
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
\`�/y(,d�t� �J l l l l
Applicant Permitee Signature Date Issued By Sig ture Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBE BOVE.
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v- 'V P O�Qos 66 � Date Re �
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CITI� OF ORONO -A'IECAA\ICAL PERMIT
i 411 Commereial permits�nutt b=appro��ed b��the Biiildins O"icial o�fnspector and/or Fire�Tarshal!)
! GL-'�L-RAL I�FORM.�.T10;�� --�
I. ��ou n�a��apply ior mechai�ical permiu b�� maii or in person at the Citv offices. .4pplications ���ill
he revie���ed and a permit���ill be issued ���ithii�t��vo�vorl;in�davs.
-- �f'I"7771T C11-4�5 ��^,l� �l�S��,r I, i�.,..,,� ..'.c^„� a`iP,� d i:A�i�Ai�li �uiii�3��icC'1. Pt}tiVii�l J :-Vftt�(��l
`�.`,L!D '.:`:';IL 1'O; �FCE';'E '� ^�r�A�iiT. �i�Oic[h t�i��i�O 1 3tGt"\� l�ATfL�[�FCE
PFR�I[T C.�RD [S POSTED O'�"THF JQB �ITE ��
��lechai�ical Des;«n�—Co�npiete calculation;. � �� iis a;�d �p:;.;',i�auc;n ;eq��_�n�cd �<,� e,,,_�h
!�ie��tin��.. ,•:.ntilatioil. hlin�idificatio��-dchumidific�tioii, and air conditionin� instaliation includin,
heat loss;'heat ��ain calculation,desisn teniperatures,equipn�ent ratin�s and identificatioi� as to
tvpe,marwfacturer and il�odei. Data shall be presented on for���provided.
4. A��hei� �n��ne�� constrtiction or remodelin_ is involved, a separate buildi»�pern�it must be
obtained.
� 111 ���ork must be done in accordance N�ith the Uniform \7echanical Code'State Building Code
requiremcnts.
C_ AlI���ork must be inspected (rou�h-in ai�d fnalj. Call (952)249-4600.
!�4-48 hour notice required)
�. House Heating Test Record must be submitted before fin�l.
� TYPE OF PERI���1(T � !
; _ (Check;',l That App;yj j
�
N
'�Resid��ntial ❑ Coi�imercial (Approval Rec�uired)
��`I A��n' [I Additional ❑ Repairs ❑ Re�lace �
� Job Site i O«�ner I»formation: i
Site :�ddress: ��1`� �jY�t�,����� �`1�.�
�
O�-vne!-: !��ai;i,1� ,1ddi�ess: ��1'y�.�
Cit�-:
_7,ip:
Hoi��e- Phone: Alternate Phone:
� Contr�ctoi- intoi•�1latio��: ;
�
Contractor: �C�L�. ��'7Y�'� C�ntact Person:
Addre��, �����n-��.�t�'i{���.. State Bond .`.
�
Cit� : (-,,.�'%�..t-'.� "/_ip;���; EzpirationDate:
� --
P�l01lC: �` " ��� ,
�n�,• '-�L� blt2� AlternatePho��e�:
❑ �nsurance- Current:
1
��EC�HANICAL�SI�STE��1S BEI\�G 1\�ST.AL1 '.= '� �� �
IIE;�TI�G SY`�TE'�'IS
Quantit�: _
\-ial:e:
\-iodel:
Fuel:
I-tue Cize:
in��ut BT��s:
Output C3TUs: _
CF\�i:
CO(�Li1G S1'STFi��SS
Quantiti�: _
\�al;e:
\-lodei:
�(lllS.
i_I. ?!1��.;...
}��IZ��f�L.��C���
❑ Gas Factoi�• Fire��lace
�
;�; A��'ood Burning i i�e},lace.
❑ ��%ood Stove
❑ «iood Stove With f lue
Brand i�'ame: '��lodel No.:
�'E\TIL:1TlON
❑ '�o. Kitcl�cn Exhaust duct recirculating cfm
❑ No. BaYh Exhaust(must have duct outside) cfm
n '�in (lthr r F�nc� i nratinnc rfn�
� ,..,. .�,,,,,, , ,,,,,,. .�.,.,...,.,,, _ ..�.
FCL•L ST'ORAGE(MUST BE.4PPROVED BY F1RE MARSHALL) �
U lilstal'lation ❑ Removal
ruel OiL �_ailons ❑ Gnder�rotmd ❑ inside ❑ Outside
LP Gas �>alloils
Other: �
(: a� L[\E O'�'LY
� O!�tdoor G�ill ❑ Other%List��Fhai&��'here:
7
'� � � PERti11T FEE C.ALCL�L�ATION(Sj I
� � � � BASED OFF - 2002 STATE ST�aTl:�E � � �
� `t'es;this section applies
Z�
The repl�cemei�t of a Residential fixture or anoliance that n�eets all three of the follo���in�,requirements:
1_ Does not require modification to electrical or�ras ser��ice.
3. Nas a total cost of S�00.00 or less excludinQ the cost of the fixtur�or apptiai�ce: and
� Is improved, ii�stalled or replaced b��the homeo��ner or licensed contractor.
Skip next se�ction_ if this�pplies: Cost of Permit S 1�.00
State SurcLa�«e � .�0
\iail-In ree i lf Appiicahiel S 7>0
�Oiai ��CI'iliii �eC S_��,�
i, � � � PE-R'��ITT�FEE C.4LC�ULATION(S)-J�OBS OVER��00.00 ����
If lbove does not a}�ply; follo��� «uid�lines belo����:
1. CO\TRACT PRICE '� is 1.2>",%of coi�tract priee���ith a(1�iniinum Tee of S3S.00)
x .012> S
. (contract pric�) �.i;inirnnn�,;:�i�ij —
2. STATE�L�RCHARGE "� Add the State Bld�Code Div. Surchar��e(:�4inimum ���c nf'S.SOi
x .0005 $
iconiract;rice) (minimum S� SO)
. POS I�GF;�: I-1,1�;DI.;�(; i���1i�; r,» \�fai�-in ;ppii.catio��sj S ].�G
4. "�O"�AI� PFFtMI'[' FEE(Add 1,ines I-� Abov�) S
• �' C`0'�TF..1CT PR10E o� !OB COST mea�;s tl�e actual o� �sti�l�ated dollar amount cLar,ed foi tl�e
��ermitted work iilcludin� n�aterilis, labor, profit, and other fixed costs. It is the amount to be cl�ar-ged
to the custo���er for the ���orl: done. If an}� material, equi��ment, labor or installations are furnislled b��
the rn��ner, tenai�t or any other }�arry, the reasonable market value of such items n�ust be� added to the
estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the
amoui�t of the job cost, the Cin� ma�r reqt�est the submissioi� of a simied cop�� of the actual contract.
• � `The STATE SC.'RC}?.AP.GE is .000>of the E3uiidin� Departn�ent at f 9��)''49-4600 for the price.
. . � ' ?�A i��..i����:����.�, C���R�i 1 T n�P Di,i�.i�i T i v�� :�v�iG.,i�v��C..��T �
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�---� -- - ---
The undersi�ned hereby applies to the Citv for issuai�ce of a Mec�l�anical Permit, a�rees to do all
�vorl< in strict accordance ���ith the ordinances of the Citv and the regulations of the State of
Minnesota, and certifies th�t all statements i��ade on this application are complete_ true and
c�;-r�c;.
i1�.�j�ilC�ilit�S SIC71l�1tLl1'P; �cZtC':� ����
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