HomeMy WebLinkAbout2005-P09137 - gas line inspection � PERMIT
C��Y OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p09137
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued:
9/2/2005
SITE ADDRESS: 825 Brown Rd S Unit#
Long Lake,MN 55356
P��� 10-117-23-21-0008
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Mechanical Permits Permit Sub-type(s): Gas Line Inspection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Run gas line to pool heater
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 900.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 37.00
APPLICANT: Ray Welter Heating Co. OWNER: Martin&Bridgett Paradise
4637 Chicago Ave S 825 Brown Rd S
Minneapolis,MN 55407 Long Lake,MN 55356
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 ISSUGD BY SIGNATURE
Copies: 1-File(SignaturesRequired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, I-Septic) Page 1
CITY �F ORONO APPLICATION FOR MECHANICAL PERMTI'
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 wichin 2 working days.
2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL 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 rype, manufacturer and model.
Data shall be presented on form provided. Identification of and specifications for water t:eating 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/Scate Building Code
requirements.
6. All work must be inspected (rough-in and final). Call 473-7357. 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 473-7357.
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Please check one: ew ✓Addition Repair Replace
�Residential Commercial
JOB srrE: S �a� z��:_ s��a�-
� Owner's Name: K��/S Telephone Number:
Mailing Address: g S ,t� - City: 0 Zip:_ 5 /
Contractor'sName: Y� , �G TelephoneNumber: J - � ' 61
MailingAddress: 6 � CK�G�I C-,d /�!-v City: S, Zip: 5
SYSTEM DESCRIPTION
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HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM: •
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons: —
H. Power
WOOD BURNING EOUIPMENT
Wood stove with flue
Wood combination or add-on
Factory fireplace with flue
Factory Fireplace (s) Freestanding Masonry
Wood Stove (s) Franklin, other
Brand Name Model No.
Mfgr's Min., Clearances, side , rear , min. flue dia.
Total
VENTILATION
N�. KitchPn Exhatast ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. O�tier Fans: Locations cfm
Total
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation Removal
Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00) ,_ �
9� . X i.2s $ �5 ,
(contract price)
2. State Surcha�e• ** Add the State Building Code Division
Surcharge to each permit. x .0005 $ �5�0
(contract price)
3. Postage and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 7.
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted
woik 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 are furnished by the owner,
tenant or any other parry 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 Ciry may request the submission of a signed copy of the actual contract.
** The STATE SURCHARGE is .0005 of the contract price under $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 Ciry 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 Minnesota
State Building Code, and certifies that all statements made on this application are complete, true
and correct.
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Applicant's Signature: � � � i' ,.� Date: ��' "✓ .
Approved By: Date:
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� Building Cocies and Standard Division
Building Codes and Standard Division commiss�oner ut Labor and Industrv
Has Received and Filed a$25,000 Surety Bond,
Commissioner of Labor and Industry As Required by MS 326.992,for Work Regulated
Has Reeeived and Filed a $25,000 Surety Bond� by the State Mechanical Code
As Required by MS 326.992, for Work Regulated To� �y N.Weltcr,Jr. Bond No: 43066493
Ray N.Welter Hcating Co. MB ID: 00253
by the State Mechanical Code EtfectiveDate Expiration Date
8/21/2005 8/20/2006
TO• Ray N.Welter,Jr. Bond No: 43066493
' Ray N.Welter Heating Co. MB ID: 00253
4637 Chicago Ave.S.
Minneapolis MN 55407
Effective Date Expiration Date
8/21/2005 8/20/2006 MB FormRC
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