HomeMy WebLinkAbout1991-003960 - mechanical .-
' PERMIT
CITY OF ORONO PERMIT TYPE. f'!Cl�•�'iHI�`�f±t:�;t_
1335 Brown Rd. South • P.O. Box 66 Permit Number: �'it"=:;'=��,r.:t
Crystal Bay, Minnesota 55323 Date Issued: `-}-�;�y�;�=�
(612) 473-7357
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APPLICANT/PERM�TEE SIGNATURE ISSUED BY:SIGNATURE
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CITY OF ORONO
. APPLICATION FOR MECHANICAL PERMIT
GFNERAT. INFORMATI ON
l. You may apply for mechanical permits by mail or in person at the City
offices. Mailed-in permits are subject to the postage and handling fees
shown below.
2. Permit cards wi]. 1 be sent by return mail the same day the application is
� received. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT
BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE.
3. When any new construction or remodeling is involved, a separate building
permit must be obtained.
4. All work must be done in accordance with State Building Code requirements.
5. AI 1 work must be inspected (rough-in and final). Cal 1 473-7357. 24-hour
notice required.
6. House Heating Test Record must be submitted before final.
INSTRQCTIONS Complete all items on this application. Compute the permit fee.
Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.
If you have questions, call 473-7357.
WALK-IN PERMITS apply at City Offices, 1335 South Brown Road (Cty. Rd 146)
MAIL-IN PERMITS enclose fee - Mail to: P.O. Box 66, Crystal Bay, MN 55323
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Please check one: New Addition Repair �Replace
JOB SITE: '�00 � ��.�r� � C� , !�� - zip:
Owner ' s Name � Telephone Number:
Mailing Address: Vt�GT 1i�'�t�ri�8WR1CaHGti'iG�'p"�cfl City: Zip:
Contractor' s Name: � Telephone Number:
Mailing Address S0.tES,qZ^G767SCF�j,��29•+1�1 City: Zip:
********************************�c***********************************************
MINIMUM FEE ( $30. 00 per project)
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SYSTEM DESCRIPTION: $15. 00 each unit
Heating Systems : l
Quantity: �
Make: ,,.`^'�� 1�-�-�-^-�-�x
Model: C;-����3� -� S C��Z��t-3 � '�� S
- F��el: ��,,�� - � ��_ _._`��'`°�-�- �,�
Flue Size. �' �
Input BTUs : �� /"� . /�5 �`�t
Output BTUs :
CFM:
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Cooling Systems:
Quantity:
Make:
Model:
Tons:
H.Power:
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� I�f--o-�-���.,--��_� �_ ./`� C'_ ' ,�
ro
� ' .
*WOOD BIIRNING EQIIIPMENT $15.00 each unit
Wood stove with flue
Wood combination or add-on unit
Factory fire�lace with flue
Factor Fireglace (s ) freestanding Masonry
Wood Stove (s ) franklin, other
Brand Name Mode 1 No.
Mfgr' s Min. , Clearances, side , rear , min. flue dia.
Total
********************************************************************************
VENTILATION $15.00 each project
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
*T^ Ct::�r Fan�: Lccations cfm
.„.
Total
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FIIEL STORAGE (must be approved by fire marshal )
' $30. 00 Permanent/Temporary
Fuel oil, gallons underground inside outside
LP Gas, gallons
Other Gas opening
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GAS LINE INSPECTION
High/Low Pressure $15. 00
;�*�****�c************************************************************************
PERMIT FEE CAIrCIILATION
1. Total of above Installations or Minimum Fee ($30.00) $ �3�', �' �
2. State Surcharge. Add the State Building Code Division
Surcharge to each Fermit $ .50
3. Postaqe and Handling on all mailed-in agplications, $ 1. 50
4. TOTAL PERMIT FEE add lines 1-3 above $ �3�� � G �
3 The undersigned hereby applies to the City of issuance of a Mec anical Permit,
agrees to do all work in strict accordance with the ordinances of the City and
: the regulations of the Minnesota State Building Code, and certifies that all
statements made on this ap�lication are complete, true and correct.
�
� Applicant' s Signature: � ¢-�; �� �-��- Date: ��' � .3 ' �� �
� �� c� S
P��►-r�* 3�'� o �a�q;� �
HOUSE HEATING TEST RECORD
ADDRESS �-� p I�-� � APT. FLOOR CITY SUBURB ����
OCCUPANT � OWNER
HEAT LOSS DATE HTG. INST. ` `
SOLD BY INSTALLED BY `�� r �L`� ' �
Electrical Work By Gas Lins By :�� � �-
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
I GAS DESIGN CONVERSION
MAKE — ^ �l� MAKE OF BURNER
Model � — � — Modei
$sriol � � Max. BTU Ratiny
INPUT �z-�� MAKE OF FURNACE
Model
� CONTROLS � '�
THERMOSTAT F� He�t Plug Vent Size
Valve � KIND OF LIN R SIZE ON
Limit Draft Hood ��i:LL � h R.��,letor �
Limit S�tting L'� Filters $ize Nu ber
Fan Setting � Chimney Location Insids t� Outside
Pilot Typs � Chimney Const►uction—� ��
Pilot Moke /J
Pilot Model � Smoke Bomb M�iring � "U`�- �
Pilot Timing ��1 �� Draft �_ Test Tay
L.W. Cut Off "�-- Door Pressure Lightin.y Inst. �/
Prossure �� `' Percent CO2 f l � Date Tested � U— L/•� -- �
Inpuf CFH ��� Percent 02��� Company Testing � � � �
Stack Temp. —�g�z ��Percent CO ���. Name of Tester
Form 235
P�z�,,-�� 3 �� o ��?� .��
HOUSE HEATING TEST RECORD
A�DRESS �v� �L' C �� a� APT. FLOOR CITY SUBURB Q"�'��
OCCUPANT r OWNER
HEAT LOSS DATE HTG. INST. �oi �
SOLD BY INSTALLED BY �' �� ��"` � ` r
Electrical Work By Gas Lins By ��,�
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE — � MAKE OF BURNER
Model � � � — —' Modal
Sxiol �� � Max. BTU Rating
INPUT '� ` ��4A, MAKE OF FURNACE
Model
�� CONTROLS ��
�..�
THERMOSTAT � egLPlug Vent Size
Valvs S ��V KIND OF UN � SIZE �,
Limit ' �� �� Draft Hood U ` ( ' ` RegulaTor D �rL���
Limit $eNing � U Filters Size Nu ber
Fon Setting— � � Chimney Locotion Inside Outside
Pilot Type ` � Chimney Construction ��
Pilot Make
Pilot Model $moke Bomb Wiring � iV� ' �
Pilot Timing � ���-�— D►aft Test Tap
L.W. Cut Off Door Pressure Lightiny Inst.
Prossure Percent COZ � L Date Tested �
�
Input CFH � Percent OZ Company Testing ��r � �
Stack Temp. —� �/�—Percent CO —P�6 t� Name of Tester �� ��, �
Form 235