HomeMy WebLinkAbout2013-00246 - mechanical � � CITY OF ORONO * Z 0 1 3 - P1 0 2 4 6 *
2750 KELLEY PARKWAY DATE ISSUED: 04/16/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2773 CASCO POINT RD
PIN : 20-ll 7-23-23-0018
LEGAL DESC : SPRING PARK
: LOT 131 BLOCK 000
PERMIT TYPE : MECHANICAL(> $500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 5,000.00
NOTE: (l)KHEEN NATURAL GAS FURNACE AND(1)KHEEN A/C
RECONNECT(3 SUPPLY AIRS
APPLICANT MECHANICAL 62.50
TONKA PLUMBING HEATING&COOL INC. STATE SURCHARGE MECH(VALUATION) 2.50
265 CTY RD 110 NORTH
MOUND, MN 55364 TOTAL 65.00
(952)472-9200 PAID WITH CC# 4708
Minnesota State License#: 060524-PM
OWNER
LARSON, REED
2773 CASCO POINT 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 E3uilding Code. This permit is for only the work described and docs
not grant permission for additional or related work which requires separate
permits. All provisions oY laws and ordinances goveming this type of work
shall be compied with whether�or not specitied 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 afrer 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.
� � �� �/ ��/ ��
A lic n P ee ture Date Issu y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Microsoft iNord - Mechanicnl Permit - Updated 07-28-11.do... http�//www.ci.orono.mn.us/vertical/Sites/{CBFC8FAF-C313...
--.----_..._______....._.
_,_ FOR CITY USE OhLY �
�r'`� � �'`� Cih�of Orono a�i3� � �
� NO� P O Box 66 Date Receiced: Prnurt#
E `750 Kellep Parl.ti��ay /�, �j�
i Cr}'stal Bay.hN�5323 Appro�-ed B}•: Amount S:(�/5�/�/
� Phone(9�2)?�39-4600 Fax(953)249--1616
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�q�.fsH����" CITY OF ORON�-'�ZF.CI�ANICAL PERn�iIT
_.: (All Conuucrcial prrmns iamst bc appi o�ed U�the Bwldmg Offic�al or Inspector and or Fue Marsltall)
_...-- ._--- —-_.__ ..-- .. __ --... __.._... ._...__...---
[ GENERAL INFORMATION
1. You may apply for mechanical pennits by uiail or in person at the City offices. Applications will
be re�•iewed and a pennit w�ill be issued w�itl�ui two working days.
2. Pennit cards«�ill be sent by rehun mail�fter a re�-iew is completed. PERMIT'S�1RE NOT
VALID L'NTII,YOL'RECEIti'E A PERNiIT. WORK':VICST I�OT BEGI1 L;nT1L THE
PERNIIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desiqns-�Camplete calculations,details and specifications are reqtiired for eacli
heating,t entilation.hiunidification-dehwnidification.and air canditioning installatio�i incltiding
tieat loss/heat aain calculatioci.desigii temperatw�es,equipmer►t ratuigs arid identificatio�i as to
type.manufachtrer and model. Data shall Ue presented on fonn pro�'ided.
4. When any nev� constiZictian or remodeling is iu��ol��ed,a separate building pennit must be
obtained.
5. .qll work miist be done in accordance with the Unifonn Mechanical Code/State Biiilding Code
requirements.
G. All���ork inust t�e inspected(roug}i-ui and fuial). Call(952)249-4600.
(24-48 hour notice requiced)
7. House EIeatin�Test Record tnust be suU�uitted before final.
TYPE OF PERMIT
(Cl�eck All That Apply)
�Resideutial ❑Conunercial(Approcal Required)
❑New ❑Additional :�,Repairs �,Replace
Job Site/Owner Infonuation:
Site Adciress: �.'1�3 C�,SLo �o►��'r��c�..
Owner: ��C�,�..r56�- Mailing�,dch-ess: �277�j Cc1S L,�p �o►��-Yc-D�
City: 1���5�� zip: SS3°1 I
Hoine Phoiie: (GIa- af1�T 7�C�' Alteiziate Phone:
Contractor Information: I
Coutractor:���C���Q I�}���(��tact Person: SC.o�"r U fGl.i�
Address: o�-�S C.z���� 4�Q� State Bond#: �'L(,�OC�J`j�
City: fl'���-� Zip:��- Expiration Date: 1`I�� I"1
Pl�one: �SZ-�1�� ��2_C�l� Altert7ate Plione: C1SZ-�}-6'0-ct a-�U-
❑ Iustuance-Current:
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MECH.ANICAL SYSTEMS BEING PVSTALLED
`ote: All Geothenual Sy`�tC111S \N1II I1UW'1CCill1IC a Sitc Plai►�.Review by our Building Ot�icial.
IS THIS GEOTHERl�iAL? ❑ Yes �,l�o
HEATItiG SYSTEMS
Quantity: `
Make: f�t+1C�l?�w�
ModeL• 1��
Fuel: �
Flue Size:
Input BTUs: ��j,.�'0(�
Output BTUs: � S'Q�_ _
__ ,--- ----
CFM:
COOLI1�iG SYSTEMS
Quaittity: 1
Make: �..lc��..fl'r"�
Model: ���<7�''n�
Tons: Z y Z �(p�-�r�
H.Power
FIREPLaCES .� .�.{ (�Jnh '�� � ��"c'`�Y�p�v� Cl�Y��-J•
o ' J
❑ Gas Factory Fireplace Brand Nune:
❑ Wood Buming Fireplace
❑ Wooci Sto��e Model No.:
❑ Wood Stove u�itli Flue/vlasonry
VENTILATION
❑ Na Kitchen E�chaust diict recirculating cfin
❑ No. Bath Exhaust(inust lia�-e dtict oirtside) cfin
❑ Iro. Otl�er Fans: Locations cfin
FL'EL STORAGE (ltifust be approved by�Fire Mnrshnll ifproyosing to nbnndon tnnk in place.)
❑ Installation ❑ Remova!
Fuel Oil: gallons ❑ Undergroiuld ❑Inside ❑dtrtside
LP Gas: galions
Other:
GAS LI1\E OtiLY
❑ Outdoor Grill ❑ Other,�List What&Where:
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� PERMIT FEE Cr�LCULATION(S) i.
! BASED OFF - 2002 STATE STATUE ;
____ _
❑ Yes,this section applies
The replacenient of a Residential fixtw•e or appiiazice that meets all ttuee of the followine requirements:
1. Does not require modification to electrical or gas service.
Z. Has a total co_st of$500.00 or less;excludin$the cost of the fixture or appliance:and
3. Is iiuproved,installed or replaced by$ie homeowYier or liceused contractor.
Skip next section,if tliis applies; Cost of Pennit $_____ I S_00
State Sw•charee � 5.00
Mail-In Fee(If Applicable) � 2.00
Total PermIt Fee S _______
_ __ _ _. w._. ...._. .._.__., __.__. .. __.
[_�µm� �W �� PERMIT FEE CALCULATION(S)—JOBS OVER$500.00
If abo�e does not apply:follow guidelines below:
1. CONTR�ICT PRICE * is 1.25%of contract price with a(Minimum Fee of S50.00)
�t�O E? �� x.0125 �
'(contract prue) (minimum$50.00)
2. STATE SL'RCHARGE ��
j�O`.� x.0005 $
(contract price)
3. POSTAGE�HANDLII�G(Only on Mail-In Applications) $ ?.00
4. TOTAL PERMIT FEE(rldd L'uies 1-3 Abot�e) S
* CONTRACT PRICE or JOB COST means die acnial or estuuated dollu� ainowit chareed for tlie
pe�Ynitted work includ'nig materials, laUor.profiL uid other fixed costs. It is the amount to be charged
to the ctistoiner for tlie work doiie. If any �iiaterial, equiptiient. laUor or iiistallatioiis are fitmis}ied by
the owner, teuant or auy other party_the reasonable market ealue of such items iuust be added to the
estiinated cost or cont��act price for pennit fee pmposes. In die e�•ent that there is a dispute on die
a�iiount of ttie job cost, tlie City inay request the subtiiission of a sianed copy of the actual coiih-act.
MECHANICAL PERIVIIT.APPLICATION AGREEMENT
T11e iuidersigiied hereby applics tu the City tor issu�uice of a Mechuiical Penuit, agrces to do all
work in strict accordu►ce with the ordinances of the City and the regulations of the 5tate of
Miimesota, a�id certifies that all staten�euts made on this application are complete, tnie and
con�ect.
Applicant's Signatiue: Date:��
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