HomeMy WebLinkAbout2006-P10356 (mechanical) PERMIT
CITY OF �RONO Permit Number:
2750 Keliey Parkway- PO Box 66 P10356
Crystal Bay, Minnesota 55323 Permit Type:
Mechanical Permits
(952) 249-4600 Date Issued: 9/21/2006
SITE ADDRESS: 3251 Casco Cir Unit#
Wayzata,MN 55391
PID: 20-117-23-43-0007
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Mechanical Permits Permit Sub-type(s): Multiple Mechanical Items
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 180.63 valuation: $ 14,450.00
State Surcharge Fee: $ �.23
TOTAL FEE: $ 187.86
APPLICANT: Owner/Self OWNER: Mark Gaylord&Lori Anderson
MN 182 2nd. St.
Excelsior,MN 55331
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
_, ; �J
�,� l�- l_�'�`.�C ��� �--�Yn �-'E-d? ����
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(SignaturesReguired), I-Applicant, 1-Monthly Reports, l-Assessing,(IfSeptic, 1-Septic) Page 1
. FOR CITY USE ONLY
04��,0 City of Orono
P.O.Box 66 Date Received: Permit#
�;.{,,, 2750 Kelley Park�vay j�..8�
� '`'�`�,.>,�;r',�' � Crystal Bay,MN 55323 Approved By: '�� � Amo�mt$:
�t���q?I'`';�y,c` (9�?)249-4600
�exo$
CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by d�e Building Official or[nspector and/or Fire Marshall)
GENERAL INF'ORMATION �
1. You may apply for mechaiucal pernuts by mail or in person at the City offices. Applications�vill
be reviewed and a permit will be issued within two working days.
2. Pern-ut cards will be sent by rehiizl mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERNIIT. �VORK MUST NOT BEGIN UNTIL THE
PERNIIT CARD IS POSTED ON THE JOB SITE.
3. Mechauical Desi�—Complete calculations, details and specifications are required for eacl:
heatin�, ventilation,hunudificatiou-dehunudification, and air conditioning installation includin�
heat loss/heat gain calculation, design teinperatures,equipment ratinas and identification as to �
type, manufacriirer and model. Data shall be presented on form provided.
4. When any new consh�uction or remodeling is involved, a separate building pernut must be
obtained.
5. All work must be done in accordance witl�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 ❑ Coinmercial(Approval Required)
�New ❑ Additional ❑Repairs ❑Replace
Job Site / O�vner Infornlation:
Site Address: ��� � �/�S�i�' �ry�(�Gt�.�� �'�Ir�C ; �-�`�-�
r�ti�'��` ��v?;r
O�vner:���-� ��v�'Cy�,��+�% Nlailin�Addre�ss: � ��- �`���� ��
! �LS`Cr��
City: �Jk=� _ Zip: �_S � j/
Home Phone: Alternate Phone: �'� 7 7 z�: ,,�---� �
Contractor Information: '
Contractor: .�`�ti��� y�g� ���ti�`�� Contact Person:
Address: State Bond �:
City: Zip: Expiration Date: _
Phone: Alternate Phone:
❑ Insurance— Cunent:
;�...
1
,:�
' ' ` MECHANICAL SYSTEMSBEING 1NSTALLED ` � `
HEATING SYSTEMS
Quantity: �
Make: G�.«'• � '�
Model: S8 W��(/glat�_F-1_ -,�rJ
Fuel: N G'�tJ�C"�
Flue Size: 3�' ���-
Input BTUs: ��� l7�
Output BTUs:
CFM: 7
COOLING SYSTEMS
Quantity: �
Make: ��_r s:� f
Model: �-�-1 1���36Ul�c`b�
Tons: .s�
H.Power
FIREPLACES
� 3 Gas Factory Fireplace
❑ Wood Burning F::epluce
❑ Wood Stove
❑ Wood Stove With Flue
Brand Name: �e�� P (� �V Model No.:
VENTILATION
g No. _� Kitchen Exhaust�duct recirculatinQ _��cfm dr (�5.�'
'� No. � Bath Exhaust(must lave duct outside) �� c ii7 cfm ���
❑ No. Other Fans: Locations cfm
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHALL)
❑ Installatiou ❑ Removal
Fuel Oil: gallons ❑ Undereround ❑ lnside ❑ Outside
LP Gas �allons �
Other:
GAS LINE ONL�'
❑ Outdoor Grill � Otl�er/List What�:tiVhere: ��`�i�C7r,,��ll�� �,.�'�
l-�,�,'��+�
�
.
' PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
❑ Yes, this section applies
The replacement of a Residential fixture or appliance that meets all tlu�ee of the following requirements:
1. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less; excludin�the cost of the fixture or appliance: and
3. Is improved,installed or replaced by the homeowner or licensed conn-actor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee (If Applicable) $ 1.50
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$35.00)
� � �,-� �o ��� X.oizs $ l ��� : ��3
(contract price) (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
l� ����% `� x.000s $ `� � Z-3
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ L�
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ I � 7 `�S"
■ * CONTR.ACT 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 ar 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.
■ ** The STATE SURCHARGE is .0005 of the Building Department at(952)249-4600 for the price.
MECHANICAL PERMIT APPLICATION 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 made on this application are complete, true and
correct.
> �� � /1 /
Applicant s Signature: Date: _� ��l /.��k%
�
�