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CITY OF ORONO PERMIT NO.: 2010-00112
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 02/26/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 2835 CASCO POINT RD
PIN : 20-117-23-31-0057
LEGAL DESC : SPRING PARK
: LOT 114 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 1,730.00
NOTE: (1)KITCHEN EXHAUS'1'-6" DUCT-425 CFM
(3)BA"I'H EXHAUST-80 CFM
(2)GASLINES TO FIRGPLACES
MOVE SOME EXISTING DUCTS FOR REMODEL PROJEC"l�.
APPLICANT MECHANICAL 50.00
ASPEN VENTILATION & HEATING CO. STATE SURCHARGE MECH (VALUATION) 0.87
9815 PIONEER TRAIL TOTAL 50.87
LORETTO, MN 55357
(763)498-7053
OWNER
IVERSEN, ROSEMARY C
2835 CASCO PT RD
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
Thc�vork f�or which this permit is issued shall bc performed according to
the approved plans and specitications,applicable Ciry approvals,and the
State 13uilding Code. This pennit is 1or only the work describcd and does
not grant permission for additional or related work which requires separatc
permits. All provisions of laws and ordinances governing 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 l80 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
I�he applicant is responsible for assuring all required inspections are
requested in conformancc with the State Building Code.This permit may be
revoked at any � for due cause.
� l � l /O �2i�(�,� � ��l �O
Applicant Permitec Signature Datc Is d I3y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE.
� � r �
FOR CITY USE ONLY
�,�` City of Orono �� �/'
O4 `rO P•O.Box 66 Date Received: Permit# ���0 ~
�, r 2750 Kelley Parkway
a �'��!;'�. a Crystal Bay,MN 55323 Approved By: Amount$: J����
m�"��j�A�,�.�o`� (952)249-4600
CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical pernlits by mail or in person at the City offices. Applications will
be reviewed and a permit will be issued within two warking days.
2. Pernut cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID LTNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desiens—Complete calculations, details and specifications are required for each
heating ventilation,humidification-dehumidification,and air conditioning installation including
heat loss/heat gain calculation, design temperatures, equipment ratings and identification as to
type,manufacturer and model. Data shall be presented on form provided.
4. When any new construction or remodeling is involved, a separate building permit must be
obtained.
5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code
requirements.
6. All wark must be inspected(rough-in and final). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
(Check All That Apply)
�Residential ❑ Commercial(Approval Required)
❑ New ❑Additional �Repairs ❑ Replace
Job Site/ Owner Information:
Site Address: � g �s �\Cc.SCo �0►'�f 2�' .
Owner:�os�e. -�v�-r�v ^ Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
�3Q�n ��;l�i�`�jl
Contractor: i`` /���,, C�.v , Contact Person: ��k �c_fi�u-
Address: �$/5 �on�zX ►c� � State Bond #: �3 � � .3 ��
�53S 7
City: �2-e-I��i��,I� Zip:(� Expiration Date: � � �f � � fl
Phone: 76.3 �{R�S 70S 3 Alternate Phone: �(Z ZZ/ 5 v7 (U
[� Insurance— Current:
1
! ti . 1
` MECHANICAL'SYSTEMS;BEING INSTALLED
Note: All Geothern�al Systems will now require a Site Plan &Review by our Building Official.
IS THIS GEOTHERMAL? ❑ Yes ❑ No
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove With Flue
VENTILATION
l�
�, No. � Kitchen Exhaust � duct recirculating 'ya� cfin
� No. _�__ Bath Exhaust(must have duct outside) �_cfm
No. Other Fans: Locations cfm
FUEL STORAGE (Must be app�•oved by Fire Marshall 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: 2 �4S ��es -� �`r e P Ia cc_S
� ��--5 2 �-r- ,(���k e. ( ��'0� tC�'
l�Oc>� s,'/It� �Xesr�� .
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� ,PERMIT��FEE CALCULATION(S)
BASED OFF - 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 tota] cost of$500.00 or less; excludinQ 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 $ .50
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
� �� � � � �� PERMIT FEE CALCULATION�(S)—JO�BS 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)
'�/73 0 ° ,
X.oizs $
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge (Minimum Fee of$.50)
x .0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
pernlitted 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, labar 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 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.
� 1VIECHANICAL 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.
Applicant's Signature: G� Date: � D�� � � �
3
� � �"' ATE TIME ✓
CITY OF ORONO CALLED IN � D
INSPECTION OTICE SCHEDULED O �
PERMIT NO. �O-d0��� co PLETED
ADDRESS �$�� � �� �
OWNER TE EPHON O. —����5d��
CONTRACTOR
>; DESCRIPTION ���i/ �'�`"�
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� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAI ❑ SEWER HOOK-UP ❑ COMPLAINT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOFi TO MEET YOU:_YES_NO
� COMMENTS:
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GW ❑WORKSATISFACTORY:PROCEED �PROJECTCOMPLETE
� ❑CORRECT WORK R PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-460�
OwnerlContractor on ite: •
Inspector._���� �1 �
White Copyllnspector's File Canary CopylSite Notice
� DAT TIME V
CITY OF ORONO CALLED IN 3-��
INSPECTION NOTICE SCHEDULED 3-3D-/O / ;,3O
PERMIT NO.�D(�J-�a��z COMPLETED
ADDRESS �83s C�.�-� Q�f"�
OWNER TELEPHONE NO. 7b3 �g� 70J��
CONTRACTOR �S�^� V�'����s
>; DESCRIPTION I �J- NIE��
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
� ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MA�NT. ❑ FOLLOW-UP
? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIONiREMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORKSATISFACTORY:PROCEED L; PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspe tion 24 hours in advance. (952� 249-4600
OwnerlContractor on site.
Inspector.
White Copy/lnspector's File Canary CopylSite Notice