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Home My WebLink About2012-01140 (mechanical- gas furnaces) • CITY OF ORONO � 0�0 1 1 4 0 * 2750 KELLEY PARKWAY DATE ISSUED: 1U08/2012 � ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3650 CASCO AVE PIN : 20-117-23-31-0043 LEGAL DESC : REG. LAND SURVEY NO. 1147 : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENT[AL CONSTRUCTIOI�T TYPE : MECHANICAL-MULTIPLE VALUATIOIV : $ 5,000.00 NOTE: 2 I3RYANT NAT GAS FURNACES APPLICANT MECHANICAL 62.50 WENZEL HVAC STATE SURCHARGE MECH(VALUATION) 2.50 4131 OLD SIBLEY MEMORIAL HWY EAGAN, MN 55122 MAIL-IN FEE 2.00 (651)894-9898 TOTAL 67.00 OWNER GERSOVITZ, MR. & MRS. 3650 CASCO AVE WAYZATA, MN 55391- ACREEMENT AND 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. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein."I'his pennit will expire and become null and void iY construction 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 conformance with the State Building Code.This permit may be revoked at any time for due cause.� �� / / Applicant Permitee Signature Date Issued By gnature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A E. .- � 1 � 3 g g FOR CITY USE ON1,Y ¢�.� City of Orono � a P.O.Box 66 Date Received: Permit# 2750 Kelley Parkway ��'�✓ Crystal Bay,MN 55323 Approved E3y: Amount$: ��r'r�'�",�,��.�� Phone(952)249-4600 Fax(952)249-4616 ��_ CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL INFORMATION 1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Permit cards will be sent by return mail afrer a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT�'ARD Ic pnSTE.�ON TH�.IOB SITE. 3. Mechanical DesiQns—Complete calculations,details and specifications are required for each heating,ventilation,humidification-dehumidification,and air conditioning installation inc(uding heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to type,manufacturer and model. Data shall be presented on form provided. 4. When any new construction or remodeling is involved,a separate building permit must be obtained. 5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code requirements. 6. All work must be inspected(rough-in and final). Call(952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before final. TYPE OF PERMIT Check All That A 1 c�Residential ❑Commercial(Approval Required) ❑New ❑Additional ❑Repairs c�]Replace 3ob Site%Owner Information: Site Address: �(.0,� t� (� 1\ /` � �/2t�2.� �n� 1'�Y1.Yl� �5 .3d1 l Ownet�n I t� �{,� D I!I�� Mailing Address: �G.YYl,� C.._J_� �,�c7�f City: Zip: Home Phone: � 5� � y�7'� � g 2�'$ Alternate Phone: Contractor Information: � �/73 e cc 7c.n r �/C� ��n.e c�. f�ru.�s�� Contractor: ____ Conta�t Person: y�y 5 o�d s�c�,y Address: �� State Bond#: �(Z�� City: �� Zip: ,�j.5/a�xpiration Date: � ) 1 `� ' a O l y Phone: (.t,)`/ ' �"! t-{' `1 $"1�' Alternate Phone: �i 5�- �`�,� • � � 02 l.0 ❑ Insurance—Current: ��p�� 1 ��i° �/�j� 3 r .- - . MECHANICAL SYSTEMS BEING INSTALLE�� ;a.f�' � ��=r}� �a Note: All Geothermal Systems will now require a Site Plan& Review by our Building Official. IS THIS GEOTHERMAL? ❑ Yes c�No HEATING SYSTEMS Quantity: � Make: "6 1/�l.' Ct,►rL�' Ntoae�: �gl„v� A�-►2d(�p�� `�SI.v� A'-i �) OQ�/� ) Fuel: Flue Size: Input BTUs: �/ 0, 6 4 n j O D p p p Output BTUs: Jr' � L, p � 9 l,l� O O O CFM: �Tp L-Z ( � � Q O COOLING SYSTEMS Quantity: Make: Model: Tons: H.Power FIREPLACES ❑ Gas Factory Fireplace Brand Name: ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTILATION ❑ No. Kitchen Exhaust duct recirculating cfm ❑ No. Bath E�aust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (Must be approved by Fire Marshal!if proposing to abandon tank in place.) ❑ Ir.sta;�atiu❑ ❑ Removal Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List What&Where: 2 j i. . . . PERMIT FEE CALCULATION(S) �'��' �� BASED OFF -2002 STATE STATUE ❑ Yes,this section applies The replacement of a Residential fixture or a�pliance 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 ner.t section,if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ PERMIT FEE CALCULATION S —JOBS OVER$500.00 :�,�' �, �`' =�� y'� If above does not apply; follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) _ 5� 0� � xA125 $ a •5 Q (contract price) (minimum$50.00) 2. STATE SURCHARGE 5, � o C� X.000s $ a. 5 0 -ntract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ LQ� � d • * 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 wark 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 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. MECHANICAL PERMIT APPLICATION AGREEMENT The undersigned hereby applies to the City for issuar�ce of a Mechanical Permit, agrees to do all work iiy strict accordance with the ordinances 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: ate:�`�j�� Reset Form 3