HomeMy WebLinkAbout2003-P06981 - heating system PERMIT
��TY O F O RO N O Permit Number:
2750 Kelley Parkway- PO Box 66 P06981
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued: 11isi2oo3
SITE ADDRESS: 680 Brown Rd S
Wayzata,MN 55391
PI D: 03-117-23-43-0003
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Mechanical Permits Pernut Sub-type(s): Heating Systems
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: PermitFee: $ 35.00 Valuation: $ 1,200.00
State Surcharge Fee: $ 0.60
Misc.Fee: $ 1.50
TOTAL FEE: $ 37.10
APPLICANT: Vogt Heating&Air Conditioning OWNER: M J OTT&S B OTT
3260 Gorham Ave 680 BROWN RD S
St. Louis Park,MN 55426 WAYZATA MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(Si�nitures Required), 1-Annlicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
- R�CEI�/ED
•�� NOV U S 2U0�
CITY OF ORONO APPLICATION FOR MECHANICAL�PE�RMITO�
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
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
LTNTIL YOU RECEIVE A PERMTT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Mechanical Designs -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. Identification of and specifications for water heating
equipment shall also be 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 work must be inspected(rough-in and final). Call (952)249-4600. 24-hour notice required.
7. House Heating Test Record must be submitted before final.
Instructions
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
(952) 249-4600.
Please check one: ❑ New ❑ Addition ❑ Repair ❑ Replace�Residential ❑ Commercial
.�
JOB SITE: c:��L:' ��"��.�' �(, a 7 �)} --�
Zip: �- ,
Owner's Name: �-�\ � . Phone Number: : i ,�- ".x -� �<�
_�, s�?
Mailing Address: City: Zip•
�i�C`i7� Fi�qTINC&AIR G�n�
Contractor's Name: '3��GORNqIy�qVF �P�`b'��hber:
Mailing Address: 5T� �'�K,MN 554 City: Zip•
_ -� SERVICE 92�-401�
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SYSTEM DESCRIPTION
HEATING SYSTEMS
Quantity: I
Make: L..�'�1 Yl C.�'�
Model: �.. ��-1—� �
Fuel: ��•�C,t`�
Flue Size:
Input BTUs: �_� �_ ����� �.��--� , ��-'�� (�L��r,��:�� /
Output BTUs: _
CFM:
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COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
a
FIREPLACES GAS LINE ONLY
❑ Gas factory fireplace ❑ Installing a Gas Line Only
❑ Wood burning factory fireplace with flue
❑ Wood Stove
❑ Wood stove with flue
Brand Name Model No.
VENTILATION
No. Kitchen Exhaust duct recalculating cfm
No. Bath Exhaust(must have duct outside) cfm
No. Other Fans: Locations cfm
FUEL STORAGE (MUST BE APPROVED BY FIl2E MARSHAL)
❑ Installation or ❑ Removal
❑ Fuel oil: gallons ❑ underground ❑ inside ❑outside
❑ LP Gas: gallons
[� Other Gas opening
2
� PERMIT FEE CALCULATION(S)
2002 State Statute ❑ 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; Cost of Permit $ 15.00
State Surcl;arge $ .50
Mail-In Fee $ 1.50
If above does not apply, follow guidelines below:
1. Contract Price* is .0125% of job with a Minimum Fee of($35.00)
--�
��1�.' �_'�-' x .0125 $ �,'�-� C����!
(contract price) (minimum$35.00)
2. State Surcharge. ** Add the State Building Code Division a Minimum Fee of($ .50)
I��, , '
x .0005 $ � �;� (��1
(contract price) (minimum$.50)
3. Posta�e and Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ �, �J
*CONTiwCT 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 installation is furnished by the owner,tenant or any other party the reasonable market value of such items
mu�t bc a?ded to the estimated cost or concract 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.
**The STATE SURCHARGE is.0005 of the contract price under S 1,000,000 or$.50-whichever is greater.For valuations over
$1,000,000 call the Department of Inspectional Services for the price.
The undersigned hereby applies to the City for issuance of a Mechanical Pernut,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
application are complete,true and correct.
��� � �
Applicant's Signature:�� '�� lJ� '�. ��«�L�� Date: � � � � �' �
Approved By: Date:
3
� � i �'�ia
, HOUSE HEATING TEST RECORD J ��' '� � �/
ADDRESS `� �� �J�� F��D "' APT. FLOOR CITY SUBURB �����
OCCUPANT OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED BY ��T7 ` ¢ t � _
El�ct►ical Work By Gas Lin� By SR�f+ —
TYPE OF HEAT GA FA HW STEAM SPACE HTR. �_UNIT HTR. OTHER
�l�i,�6KA5 DESIGN CONVERSION
MAKE MAKE OF BURNER
Mod.l Mod.l
Swial � d.� Max. BTU Roti�q
INPUT ���U��"�� MAKE OF FURNACE
Mod.l _
-�� CONTROLS � (1
THERMOSTAT ��''� H f Pluq '�� V•�t 5i:._
Valv � �-��� KIND OF LINER SIZE �0�
Limit s ���"�L� Drah Hood l�V��� R�qulawr_.�_��`�� �
c
Limit S�ttiny Filt�rs Si:• ►�umb�r
Fan S�ttinp � � � � � t3�imn�r Location I�sid� X �/ Outsid
Pilot Typ� y ' ��'�/�' Chimrnr Co�struction � � L..I��S-S � —
Pilot Mak• �
Pilot Mod�l '�Z� L�r ' �`��� Smok� Bomb Wirinq
Pilot Timin9 � S� Droft T�st Taq
L.W. Cut Off ' Door Pr�ssw� Liqhtiny Inst.
� — 3c�-c��
Pr�asun + P��c�nt CO2 �` Dat� T�st�d �
Input CFH L��� P�rc�nt 0� � Company T�stiny ) '
Sroek T•rnp. P..e.n� CO ���� Na� of T�st�r � �