HomeMy WebLinkAbout2016-00065 - mechanical � � CITY OF ORONO * Z 0 1 6 - 0 0 0 6 5 *
2750 KELLEY PARKWAY DATE ISSUED: OU19/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 980 FERNDALE RD W
PIN : 02-117-23-44-0019
LEGAL DESC : COUNTRY CLUB ESTATES
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHAN[CAL-MULTIPLE
VALUATION : $ 15,000.00
NOTE: (2)LENNOX FURNACES
(2)LENNOX A/C UNITS
APPLICANT MECHANICAL 187.50
STATE SURCHARGE MECH(VALUATION) 7.50
GOLDEN VALLEY HEATING&AIR MAIL-IN FEE 2.00
5182 WEST BROADWAY
CRYSTAL,MN 55429- TOTAL 197.00
(612)535-2000 Payment(s)
CREDIT CARD 7420 197.00
OWNER
WANG, EDWARD
980 FERNDALE RD W
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
Ihe 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 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 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.
o �' l � ��� ��
Applicant Permitee Signature Date Issued B 'gnature Date
01/19/2016 11:10 7635354379 GOLDEN VALLEY HTG PAGE 01/04
FOR TY US�ONLY" �
City of Orono I /�-�
���j-� P.O.�ox 66 Datc Rec�iv c� Permit#� V�
�J ?75Q Kelley Parkway
Crystal Bay,MN 55323 Approved y; Amount 5;
Phone(95Z)2q9-4600 Fax(952)249-�1G16 � / /
���� ��'� CTTX OF OR
�FSF-ioR O�TO—MECHANIC,A►,�,�ERMZ7'
(All Commcrcial pcm�its must be approvcd by thc Building O�cia!or Inspccmr and/or Pirc Maisball)
GENER.AL 1NFORMAT'ION
1. You may apply fo�n�echanical petmits by�x�,ail or in persa�at the City offiees. ,q,pplieations will
be reviewed and a pem�it will be issued wi2hin two working days,
2. Pertnit cards will be sent by return mail a�ter a review is completed. PERM['�'S AIZE NO�'
VA,J..JD UNTIL XOIJ RECEIV� A pERM�T, WO�R MUST NO`�'�LGIN UNTIL T[��
�ERMIT CA,Rb IS POST'ED ON THE JOB SITE
3- Mechanical Desi�ns—Complete ca�ciilations,details and specificatiozas are required f"or eack�
heacing,ventilation,hurr)zdx�Cat.ion-dehuztlidificatiprl,and air co�adicioning znstallation including
heat Ioss/heat gain calculation,design temperatuXes,cquipment zatings ar�d identification As to
type,rnanufacture�r astd mode�. Data sha��be prescnted on Form provided.
4. W�,en any new construciaon or rcmodeiit2g is involved,a se�a�ate building�ermit must be
obtai�ed.
5. All work mvst be donc in accordance with the Uni�orm Meehar�ical Code/State Building Code
requirements.
6. A!I work must be inspected(rough-in and final). Ca�l(952)249-4600.
(Z4-4R hour notice required)
7. House F-Ieating rest Record must be submittcd before final.
TX�E OF PERMIT
Chec,�All Tk�at A 1
`�Residential ��omzzaercial(Appxoval Required)
❑ New ❑Additional [�Repairs ❑ �ieplaca
3ob Site/Owner��a:formatiox�:
Site Address: ��/ � � �
Owner: �JV� � Mailiz�g Address:
J G
c��: �. �� z;�: _ � �3 R � _
Hazz�e Phone; 1`�� �� � �
Alternate Phone:
Co�tractor�format�o�a:
Cont;ractor: (� �� Co�,tact Person_
5182 V�ST BROADwAY�
Addz-ess: State Bond#:
����N r�-53s 2aoo
C�tY� Zap: Expiratioz� Z7ate:
Pk�o�ne: ,Alternate ��one:
❑ Insuranc�—Cunent:
1
01/19/2016 11:10 7635354379 GOLDEN VALLEY HTG PAGE 02/04
��EC�A�I��,�S'�ST^�11+�-��E�N�TNSTt1�'LED.
Note:All Geothexxaaal SysceXns will z�ow requ�xe a S�t� lan& eview by our Buildizzg Offic�al.
IS T�S GEOTN�RMAL? ❑Xes�o
HEATX1�iG SYSTEMS
Quantity: �-
Make: {/� . F
ModeI; �q(DUfdf'�rI ��� u(7� �lD
Fuel: `!►Q-'Q
��
�lue Size:
�nput BT'[Js: �L/ (/�� ���^
Output BTUs: ld �G� ��
CFM:
COOLING SXSTEIV[$
QUa�taTy� � �
Make: ��f�V� U�-� �I/U �
�oa��: �� �(f �%�J I�19[,�CC�,�J�
� ��'ons: �
H. �ower
FIR�PLACES
❑ Gas k'actory Fixeplace Srand Name:
0 Wood Burning Fireplace
❑ Wood Stvve Mod�l No.=
❑ Wood StovC wit�,�Flue/Masonry
V N7'ILA i N
❑ No. Kitche��xhaust duct recirculating cfrn
❑ No. Bath Exhaust(�zust have duct outside) cfm
❑ No. Other Fa�s; Locations cfrn
�L ST GE (Must be approved by FYre 1Vlarshall if proposing to aba.�don tank rn place.)
� Installation ❑ Removal
Fuel0il: gallons Q Under ound
gr []Inside ❑Oul9ide
�.P Gas: gallo�s
Otk�er:
GAS Ll � 1�TLY
❑ Outdoor Grill ❑ Othe.r/List What&Where:
2
01/19/2016 11:10 7635354379 GOLDEN VALLEY HTG PAGE 03/04
��� �� ,�
�MIT.��� C�LC��,TIO�(�� ,
� BASED 0�'��' .:20q2 STATE.��'A� ;,, �, ' ;,
❑ Xes,this sectzom applies
The replaccment of a Rcside tial fixtu e or a ]iance that meets all three of the�'ollowing requirements:
1. Does not�equire rtaodif cation to electrieal or gas service.
2. Has a total cost of$500.00 ar less;exeludina the cost of the fixture ox appliance:and
3. Is imprpvcd,installed or repEaeed by the hpmeowner or licensed contractor.
Skip next seetion, if th[s applies; Cost o�'Pertr�it $ 15.q0
State Surcba�ge $ L.00
l�az�-1n�'ee(If Applicable) � 2.00
Total�erimit Fee �
�'ERMIT'�E� CAL��:7;j.;ATI0�1 ,�)-:,JQ�S OV�R 50';�:00
ZFabove does not apply;fo�low gui�ielin,es below:
1. CONT�tA,CT PRICE * is 1.25%of coritract p��ice with a(Minimum Fee of�50.00)
Ix.0125 $ , ��
(con ct price) (minimum$50.00)
2. STATE SURCHARGE �� �� �-l
x.0005 � U
(contra i pricc)
3_ POSTAGE&HANDLI�IG(Only on ivxail-In Appl�cations) � �2. ,
� a—D
4. '�QTAL YERMIT FE�(A,dd Lines 1-3 A,bove) g j �
` * CON�'�ACT PRICE or JOB COS'�' means the actual or estirnated dollar amount chargcd �or the
permitted wo�k inciuding materials, labor,�rofie,and otl�ex fixed costs. it is the amouac ro be char�ed
to the custotl�e;r for the work done. If any material, equipment, laboz•or installations arc fi�rnished by
the ow�nez�, tenant or az�y othcr party,the roasonabte market value of such items must be added to The
estin�ated eost or contract pz�ce fox' �ermit fee �urposes_ Z�� the evcnt that therc is a dis�ute on tk�e
at�ount of the job �ost, the City may requesf the suba�,ission of a signed copy of the acCuA] contract.
;. 1VI;EG�Z��;:�E1�MIT��LTQATZ��1 A�RE��:�,�`�TT
_ ��
The u�dersigned h�,reby a�plies to the C�ty for issuaz�ce of a Mechanxea� �ermit, agxees to do al�
work i� strict acco:rdance witk� t�te ordiqa�ees of the City and the regulations of tk�e State of
l�i�.z�esota, and ce�tifies that all statemez�ts made on this application are complete, tnie and
correct.
) ` 1
Appl�cant's Signatuxe� bate:
3
� I � -- �
v � T TIME
CITY OF ORONO CALLED IN -
INSPECTION N TICE SCHEDULED - 3/�! //:
PERMIT NO. �d/�-G'YX bs C PLETED
ADDRESS
OWNER TELEP NE NO. ' D a
CONTRACTOR ' � ���
� DESCRIPTION � TL%�'(�Gt�C
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLO�-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
WNERf RACTOFi TO MEET YOU:�fES_NO
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� COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED OJECT COMPLEfE
� ❑CORRECT WORK 8 PROCEED ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 urs in advance. �95 - 6QQ
OwnerfContractor on site:
Inspector.
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