HomeMy WebLinkAbout2015-00016 - mechanical CITY OF ORONO * Z 0 1 5 - 0 0 0 1 6 *
' - 2750 KELLEY PARKWAY DATE ISSUED: 01105/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 1629 BOHNS POINT RD
PIN : 17-117-23-11-0005
LEGAL DESC : REG. LAND SURVEY NO. 0565
: C,OT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTIOi�1 TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 14,622.00
NOTE: (2)CARRIER FURNACES AND(2)CARRIER A/C UNITS
APPLICANT MECHANICAL 182.78
STATE SURCHARGE MECH(VALUATION) 7.31
PEAK HEATING&COOLING, INC. TOTAL 190.09
7801 PARK DR. Payment(s)
CHANHASSEN,MN 55317 CHECK 6832 190.09
(952)401-1195
Minnesota State License#: mech-MB003156
OWNER
GREEN, RANDALL
1629 BOHNS PT RD
WAYZATA, MN 55391-
AGREEMENT 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 addi[ional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within l80 days of the date of issuance,or if construction is
suspended for a period of l80 days at any time after work has commenced.
e applicant is responsible for assuring alI required inspections are
re sted in confo nce tate Building Code.This permit may be
revo e' any time ue ause.
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Applicant .ermitee gn tu Date Issu By Signature Date
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� � �_�__ FOR CTTY USE ONLY
City of Orono
� �Q�,~\� P.O.Box 66 Date Rcccived: Pcrmit#
i 0 2750 Kelley Pazkway
�, Crystal Bay,MN 55323 Approved By: Amount$:
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Phone(952)249-4600 Fax(952)249-4616
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���.�,�.�5�����,,/ 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. Pernut 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
type,manufacturer and model. Data shall be presented on form provided.
4. When any new construction ar 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
requuements.
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
�Residential ❑ Commercial(Approval Required)
❑ New ❑Additional ❑Repairs �eplace
Job Site 1 Owner Information:
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Site Address: /(rr ' bnhrt �vyv�
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Owner�G(-rD��'n� �i'�A%i.r ��Z MailingAddress: �(���/ b�/Z.�ti 1�� ��l
City: (/T/K�/7a� Zip: �����
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Home Phone: �(� '�-�/�, //'j Alternate Phone:
Contractor Information:
Contrac�or: � - u '' , v�ll�'y Contact Person: i �
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Address: +�/ � / S� � State Bond#: /�� c:(: �a r�(.
City: �J'lyvi.t�S,-v� Zip: fi�,�i�'Expiration Date: � ' ?j �'�/
Phone: �S�- ��Ul'�``� � AlternatePhone: 1S�- �l�y `1��--�
� Insurance-Current: �u� ���5
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MECHANICAL SYSTEMS BETNG INSTALLED
Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑ Yes ,�No
HEATING SYSTEMS
Quantiry:
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Make: ��,.f r1Yl
ModeL• ,��CYA viU
Fuel: �/��
Flue Size:
Input BTUs: Q�
Output BTUs: ��
CFM:
COOLING SYSTEMS
Quantity:
Make: ��ui3,ef
Model: ��/���
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Tons: ����
H.Power
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTTLATION
❑ Na Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfin
FUEL STORAGE (Must be approved by Fire Marsha[I if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
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� PERMIT FEE CALCULATION(S)
BASED ��'F -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;excluding 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 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
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
`% �a�v�'� x.0125$
�(contract 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) $ /D'v
■ * 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 far 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.
MECHAI�TICAL PERMIT APPLICATICIN AGREEMENT
The undersigned hereby applies to the City 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 State of
Minnesota, and certifies that all statements ade on this application are complete, true and
correct.
Applicant's Signature: Date:��� ��
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