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Home My WebLink About1986-8684 (mechanical) GENERAL PERMIT CITY PERMIT N� 8 6 8 4 CITY OF ORONO P.O. BOX 66 Date J�� CRYSTAL BAY, MINNESOTA 55323 (612)473-7357 Owner //� �-�1 � Address � � ��I `�� 2 � Contractor �SZ.X_Sl ��'� - Address �� y' �rS �� " � T City License No. �"' � �� City � C� �,S� C �� REMARKS AND SPECIAL CONDITIONS ,�� c 14 � PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR ❑ REMODEL Inside Plumbing (#fixtures ) Fee $ Water Well Fee $ Water Meter(Size ) Fee $ Mechanical Equipment Fee $ ��5`� Meter# Fireplace/Wood Stove Fee $ Remote# Moving/Lifting Buildings Fee $ Municipal Water Connection Fee $ Land Alteration(Excavation, ❑ Copper ❑ Grading, Filling etc.) Fee $ Design Review Fee $ Municipal Sewer Connection Fee $ Fire — Fee $ ❑ PVC ❑ Cast ❑ Sprinkler System (Fire) Fee $ MW CC SAC Charge Fee $ � -� Other:��--��'� - �"''�-- Fee $ /�� On Site Spetic System Fee $ After-the-fact Investigation Fee $ ACKNOWLEDGEMENT TOTAL State Surcharge: Fee $ � � The undersigned hereby acknowledges receipt of this limited permit, ��,. � including acceptance of all special information, terms, conditions or Total Amount Paid to City F88 $ reqwremen[s wntten above. ThC undersigned understands and agrees under penalty of law tha[this permit is stricdy limited in scope to[he work, activity or improvement specified; that this permit dces not grant any authority rodo work or activities reyuiring separate permit approvals:and that[his permit does notgrantauthority to violate any provision of any City ordinance or State law,rule or regulation.All work shall be done in strict This permit is not valid until the proper fee is paid and it is approved compliance with all City ordinances, building codes and/or health department regulations,and shall be subject to inspection,approval or by an authorized City Ot�icial. rejection by the City. Whenever so ordered,the undersigned agrees ro correct anv work found to be in violation of the conditions of this permit. Signature of Applicant Signature of �ty Official ,' ��G�--�-�/--�� _ c'�-�--�.� -�--� , Code: White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold Applicant's Receipt • ;i ��p�'---, � d --L�,�;: CITY OF ORONO �" c�,� + 5 ` wGr" /�e„ APPLICATION FOR MECHANICAL PERMIT �� GENERAL INFORMATION ��-Jj --_..r� , l . You may apply for mechanical permits by maiJ or in person at the City offices. Mailed-in permits are subject to the postage and handling fees sho�•m below. � 2 . Permit cards will be sert by return mail the same day the application is received. PERA9ITS AFtE NOT VAL1D UN'I�IL YOL' RECEIVE A PERMIT. WORR MUST NOT BEGIP� Ui�TIL THE PERD9IT CARD IS POSTED ON THE JOB SITE. 3 . When any new construction or remodeling is involved , a separate building permit must be obtained. 4 . All work must be done in accordance with State Building Code requirements . S . All work must be inspected (rough-in and final ). Cal ]. 473-7357. 24- hour notice required. 6 . 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. I2�COMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 473-7357 . j•;ALK-IN PERI,�ITS apply at City Offices, 1335 South Brown Road (Cty. Rd 146 ) _ --- ___ MAIL-IN PERMITS enclose fee - riail to:( P.O�. Box 66 , Crystal Bay, MN 5��, ***********i:****************�**********`�F�-********************************* JOB SITE �/"y�a�-� �,1�,��1 ) �j,,� Owner ' s Name � ,� � �. �' �- Telephone Number � - �_�''_,2 �i t�ailing Address ��-i� ,y Contractor ' s Name � � , , > - ' Telephone Number ' _• --r� 7 I�� Nailing Address ' � � ' � � ��L � � d /� ��' �'��i� �ir�� _�;�c � �..� **************�************************�,********** ************************ MINIMUM FEE ($25 . 00 per project) *************************************************************************** HEATING SYSTEMS $20. 00 each unit FUEL nat. gas, lp gas, oil, elect. other (specify if combination burner ) �� EQUIP. (if more than 1 unit per bldg. list each separately ) ,5� ' ,n NO. TYPE BTUH IMPUT BRAND NAME MODEL N0. / .��' ��Y f .a. furnace _--- —L hw boi ler �'�c? ��-�' �.t�1.C. 1',�'.��t,t �� c-� unit heater solar htg. equipment � -�% Solar Equipment $50. 00 each system Total �� ***************************�*�********************�***� ********* *********** �/Le�v� c�.��C�h�e�.o . - AIR CONDITIONING $20. 00 each unit Central Air Separate Central. Air System w/f urna ce Brand name Model No. Tons � Total *************************************************************************** *WOOD BURNING EQUIPMENT No charge Wood stove with flue No charge [aood combination or add-on unit $30. 00 .each unit Factory fireplace with flue Factor Fireplace (s ) freestanding built-in �ti�ood Stove ( s ) franklin, otl�er Brand Name r9ode 1 No. Mfgr ' s Min. , Clearances, side , rear , min. flue dia . Total **********�****�;****�*******************�*****************�**************�,* �TENTILATION $S. uO each exhaust fans, (bath, kitchen, attic, etc. ) No. Kitchen Exhaust ducted recirculating cfrn No. Bath Exhaust (must be ducted outside ) cfm No. Other Fans : Locations cfm Total **********�**�***************************�***�,****�***�;��******************* FUEL STORAGE (must be approved by fire marshal ) $20 . 00 Permanent $10. 00 Temporary Fuel oil , gallons underground inside outside LP Gas, gallons Other ***********�****�;****��*********�;*******************�;****��***************** SPRINRLER SYSTEMS Minimum $20 . 00 each system Number of heads No. of Risers $2. 00 per head *******************�*********************��*�:********�********************* PERMIT FEE CALCULATION 1 . Total of above Installations or Minimum Fee ( $25 . 00 ) $ vj,j.``�' 2 . State Surcharge. Add the State Building Code Division Surcharge tc each permit $ . 50 3 . Postage and Hand�linq on all mailed-in applications, $ 1 . 50 4 . TOTAL PFRI•9IT FEE adci lines 1-3 above $ ,,� �, �-�� The undersigned hereby applies to the City of issuance of a Mechanical Permit, agrees to do all work in strict accordance with the ordinances of the City and the. regulations of the N,innesota State Building Code, and certifies that all statements made on this application are complete, true and correct. � Applicant � .f�.�►,�-,,�� ,��I Date �l - /C -�� * WOOD BURNING STOVES Please note that there is no longer a fee for wood burning stove permits. We do however still require a permit to be issued. If the permit application is mailed in we do require a $1.50 char.ge for postage and handling. ��,��y HOUSE HEATING TEST RECORD ADDRESS �/ 2'S �"�f`�A C''L� APT. FLOOR CITY SUBURB�c��'� , OCCUPANT � �.• OWNER �� HEAT LOSS DATE HTG. INST. � SOLD BY INSTALLED BY _ � ''�� . � �. J /� Electrical Work By �� Gas Line By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER , GA DESIGN CONVERSION ' MAKE �C '�"►`-' � MAKE OF BURNER (Q Model ` Model $erial P � Max. BTU Rating INPUT � MAKE OF FURNACE Model " CO ROLS 3 .yC�� THERMO T eat Plug�'—" Vent Size .7�/ ��A��—`°�"`'''r��'`��"i. �-'��• Valve ` KIND OF LIN R SIZE NONE Limit � Draft Hood Regularor Limit Setting Filters Size �� Number Fan Setting �i, Chimney Location Insids � Outside Pilot Type Chimney Construction Pilot Make � • - // Pilot Model �� $moke Bomb � Wiring �/�-� Pilot Timing �v�'d • Draft �'est Tay �'A L.W. Cut Off a.�'� Door Pressure Lighting l�st.� Pressura � S 1 Percent CO2 �`� Date Tested ` Input CFH � � ' Percent OZ Company Testing $tack Temp. � Percent CO �"t" Name of Tester � Form 235 HOUSE HEATING TEST RECORD ADDRESS �- - � � � -" �%' " � � APT. FLOOR CITY SUBURB ��L�� OCCUPANT ��`� 7� ' OWNER HEAT LOSS DATE HTG. INST� SOLD BY INSTALLED BY Electrical Work By Gas Line By TYPE OF HEAT GA FA �� HW STEAM SPACE HTR. UNIT HTR. OTHER /r � GAS g�51GN =-� �,�r MAKE �-��ifw� � ��f� MAKE OF BURNER ' -' � ��' ,� �1\'�� Model �t�� .+ Model - ` �_. f 0 � �S'.)�.` �-�. Serial �/ �3�� Max. BTU Rating ' INPUT _!��n� MAKE OF FURNACE S - Model !�` � �`�� CONTROLS / ,� � �.�-r.;,.,.'.'`::. ... . .. THERMOSTAJT �'�r Heat Plug � T Vent Size +Z � -' Valve r�./�� KIND OF LINER SIZE NONE Limit ��•�j Draft Hood y� Regularor / Limit Setting Filters Size ��/� � 5 � Number / Fan Setting Chimney Location Inside '� Outside i� G� Pilot Type � �.�- Chimney Construction /Z T �,L Pilot Make Pilot Model Smoke Bomb �Wiring Pilot Timing Draft �G~`L'�C..l� Test Tag `—' L.W. Cut Off Door Pressure Lighting Inst. �- `_ `�' Pressure—� �` Percent CO2 �-`� Dote Testad . � l C � D /, Input CFH��y C' Percent OZ—_�� Company Testing ��'� j � $tack Temp. —L-� —Percent CO — — Name of Tester Form 235