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Home My WebLink About2011-01477 - mechanical � ' CITY OF ORONO PERMIT NO.: 20��-014�� 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssuEn: 1 U23/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 1635 BOHNS POINT RD PIN : 17-117-23-11-0006 LEGAL DESC : REG. LAND SURVEY NO. 0565 : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : MECHANICAL-MULT[PLE VALUATION : $ 24,000.00 NOTE: (1)BRYANT HTG SYSTEM-NATURAL GAS-2°FLUE-80K INPUT,76K OUTPUT, 1,000 CFM (1)MODINE HTG SYS"CEM-HOT DAQG-NATURAL GAS-4°FLUE-40K INPUT,32K OUTPUT (1)K[TCHEN EXHAUST-DUCT-300 CFM (5)BATH EXHAUST 50-100 CFM (l)DRYER VENT-250 CFM GASLINE FOR OUTDOOR GRILL APPLICANT MECHANICAL 300.00 AIR QUALITY SERVICES, INC. STATE SURCHARGE MECH (VALUATION) 12.00 6221 CAMBRIDGE STREET TOTAL 312.00 BOX A6 ST LOUIS PARK, MN 5541Cr (952)928-3835 OWNER KOZLAK, STNICK&JODEE 1635 BOHNS PT RD WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permi[is issued shall be performed according to the approved plans and specitications,applicable City approvais,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 whe[her or not specified herein.This permi[will cxpire and become null and void if construc[ion 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 after work has commenced. The applicant is responsible for assuring all required inspections are requested in confor ance it the Sta[e Building Code.This permit may be revoked at any t for d c use. .--7 , � l•� � � L � � /�:� � �� plicant Permitee Signature Date [ssue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. t t � F R CI Y USE ONLY I ,¢p�, City of Orono 3 t'� �-7 7 P.O.Box 66 Date Receiv� : Permit#` � ' " ��;, � 2750 Kelley Parkway �a � ?�� Crystal Bay,MN 55323 Approved By: Amount$: ��, � ��'��`',�� o`� Phone(952)249-4600 Fax(952)249-4616 ��R(3o$� CITY OF ORONO —MECHANICAL PERMIT (� � � 2�J� (All Commercial permits must be approved by the Building Official or Inspector andlor Fire Marshall) GENERAL INFORMATION 1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be reviewed and a pernut 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 UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desi�—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. 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. (24-48 hour notice required) 7. House Heating Test Record must be submitted before final. TYPE OF PERMIT (Check All That Apply) �� Residential ❑ Commercial(Approva]Required) � ❑ New �Additional �2f i'uvJ ❑ Repairs ❑Replace Job Site/ Owner Information: Site Address: ��JJ ��j�w�5 �� . � Owner: /UrCi� �:i��L/�� MailingAddress: ��v3� l�C�.�.sP�; � c�ty: Dl�-,� z�p: s 5s� t� Home Phone: Alternate Phone: Contractor Information: � ' � / Contractor: ' � � �s -�y�"L';�� Contact Person: �r'� ��vt �l.�aG�, Address: �� Cct,��;��c:� J T, A�State Bond#: _j��.S�J��fi City: ` � � Zip:JS�%/�p Expiration Date: 7' Z�'�� Phone: /�Z`�/Z`�'3�� Alternate Phone: � Insurance—Current: �S 1 1 � i :� � � � � � � �� ,� .:._, , F -�, � � '�'�� .�°��, �'' . ,. s�< Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. IS THIS GEOTHERMAL? ❑ Yes �No HEATING SYSTEMS Quantity: � � � L �/ Make: b�2��,ti,y ��ol�j/t� ModeL 35��`'L��2D40 /�'�T G�'' Fuel: rCJ /U� Flue Size: Z'' Fv� �/''` Input BTUs: �� f�f� Output BTUs: 7�D l� � CFM: /�j� COOLING SYSTEMS Quantity: � Make: ,b:��,,� Model: �Z�F b'�/�� C Tons: �%J H.Power FIREPLACES ❑ Gas Factory Fireplace Brand Name: ❑ Wood Buming Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTILATION � No. � Kitchen Exhaust � duct recirculating �� cfm No. �" Bath Exhaust(must have duct outside) ,5"U'I/D cfm No. _� Other Fans: Locations ,C�,��t N./ ✓�.,,�' Z,5 .� cfm FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in p[ace.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside LP Gas: gallons Other: GAS LINE ONLY � Outdoor Grill ❑ Other/List What&Where: � 2 f � � � � PERMIT FEE CALCULATION(S)� BASED OFF -�2002 STATE STATUE � � � ❑ 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; excludine the cost of the fixture or appliance: and 3. Is improved, installed or replaced by the homeowner or licensed contractor. Skip next section, if this applies; Cost of Pernut $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ PERivIIT FEE CALCU�ATION(S)'-70BS OVER$500.00 �� `��'� If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) a C/vv x.0125 $ (co ct price) (minimum$50.00) 2. STATE SURCHARGE x.0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ • * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted 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 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 pernut 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. � ...�. ��E�� `' "�� :�'.� .x�� ' ��° € ,��; The undersigned hereby applies to the City far issuance of a Mechanical Permit, agrees to do all work in strict accordance with the ardinances 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 Signature: �'G%lC�'/�.{✓h- Date: ��'�� 3 �� ATE / ' TIME v CITY OF ORONO CALLED IN �� l�� ! INSPECTION NOT C SCHEDULED � PERMIT NO. d�� 77 M LETED ADDRESS � OWNER ' L �HONE NO. � ��'� � CONTRACTOR � DESCRIPTION ` ' " ► � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILIING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O '' /�/1 P4 n t� .n,� � �-�zl` `�7_C' S �.' �.�- � � �: �1 /� � �� c� � Q � z W � W � j GW lORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTfON REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-460� Owner/Contractor on site: Inspector. � � White Copyllnspector's File Canary CopylSite Notice � � �/� ✓ � � D TE TIME CITY O ORONO 1iJCALLED IN �� -� / INSPECTION NOTICE ��,`�/� SCHEDULED � �� ' � �i' PERMIT NO. ��T�l COMp�LETED .�,� . ADDRESS I�'� ��"? ��';� )� :y; j/r �./, OWNER TELEPHONE NO. � �� CONTRACTOR �' `� �'��f�-� � '1� !1r .� /, / � L-'�/, / � DESCRIPTION ,�� - �� --= � =� �- � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/RIL'LING /f�� Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Z Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC AL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEEf YOU:�ES_NO ._.--__-- -- � COMMENTS: � W 0. � J O a � O � W � Q ti Z W � W � � GW�ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next' �tion 24 hours in advance. �952� 249-Q6�� OwnerlContractor s' Inspector. ' White Copyllnspector's File Canary Copy/Site Notice