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Home My WebLink About1985-8149 - general permit GEI�TERAL PERMIT CITYPERMITNO. g149 CITY OF ORONO , _ P.O.BOX 66 Date ��' �� CRYSTAL BAY, MINNESOTA 55323 (612) 473-7357 Owner ' J I �'� �-''C- � � I S� � Address fi fj n Contractor �� Address _ ��t � �� _� (� f� .�"�-� i`-c� . City License No. � � �� State License No. ��i��-~�� REMARKS AND SPECIAL CONDITIONS PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR Inside Plumbing (#fixtures_) Fee $ Water Well Fee $ Water Meter (Size—) Fee $ Mechanical Equipment Fee $� �, �>�-� Meter# Remote;� Moving /Lifting Buildings Fee $ Municipal Water Connection Fee $ Land Alteration (Excavation, Fee $ � Grading, Filling, etc.) ❑Copper Municipal Sewer Connection Fee $ — - Fire Fee $ ❑ PVC ❑Cast n Sprinkler System (Fire) Fee $ MWCC SAC Charge Fee $ Other:� ��c � �'c _ Fee $ / ,�� On Site Septic System Fee $ After-the-fact Investigation Fee $ ACKNOWLEDGEMENT TOTAL The undersigned hereby acknowledges receipt of this limited permit, including acceptance of all special information, � tertns, conditions or requirements written above. The undersigned understands and agrees under penalty of law State Surcharge: Fee $ � that this permit is strictly limited in scope to the work, activity or ixnprovement sPecified; that this permit does jl/ not grant any authority to do work or activities requiring Total Amount Paid to City Fee $ <<-�� sepazate permit approvals; and that this permit does not grant authority to violate any provision of any City ordinance or State law,rule or regulation. All work shall be done in strict compliance with all City ordinances,building codes �aior health department regulations, �a Sn$u be This permit is not valid until the proper fee is paid and subiect to inspection, anuroval or reiection by the c�cv. it is approved by an authorized City Official. Whenever so ordered, the undersigned agrees to conect any work found to be in violation of the conditions of this permit. Signature of Applicant Signa ure of City Official . �� ., � _'�.1---- �'� �� Code:White—File Copy Canazy—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt r_ � ��-��;`;��.,�, � , �� pCT 2 s �9�i - �,i - �� _____�;.� CITY OF ORONO �, �.�'l.�.�[��-��' APPLICATION FOR MECHANICAL PERMIT GENERAL INFORMATION 1 . You may apply for mechanical permits by mail or in person at the City offices. Mailed-in permits are subject to the postage and handling fees shown below. 2 . Permit cards will be sent by return mail the same day the application is received. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT EARD 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. 5 . All work must be inspected (rough-in and final). Call 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. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 473-7357 . WALK-IN PERMITS apply at City Offices, 1335 South Brown Road (Cty. Rd 146) MAIL-IN PERMITS enclose fee - Mail to: P.O. Box 66 , Crystal Bay, MN 55323 ***************** �t****�� ***/***�******************************************* JOB SITE �� 'i J ��,(,G,t'�, ��,%�.4 �� __ Owner ' s Name �� ;� , � �,� ,, ,• . Telephone Number ' -,�, - Mailing Address .'"-r :, ;� . Contractor ' s Name ` �,-;, � �`"�� , _ � � !� Te]�ephpne Number '` ' _, ;; =j � Mailing Address �j� „ ; � �,;� .,� , 1,�� + ,.` /�/�f � � ' ********************��**��************** ******* *******�************** MINIMUM FEE `( �25. 00 per project,) ' ************** �r�********************************************* 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) NO. TYPE BTUH IMPUT BRAND NAME MODEL NO. �_ f .a. furnace _ �'� , �-r-z� ! , � . � �� C.`�';�. ,�. hw boiler unit heater solar htg. equipment ��_ Solar Equipment $50. 00 each system Total .�� *******************�******************************************************* AIR CONDITIONING $20. 00 each unit Central Air Separate Central Air System w/f urnace Brand name Model No. Tons Total *************************************************************************** *WOOD BURNING EQUIPMENT No charge Wood stove with flue No charge Wood combination or add-on unit $30. 00 each unit Factory fireplace with flue Factor Fireplace (s ) freestanding built-in Wood Stove ( s ) franklin, other Brand Name Mode 1 No. Mfgr ' s Min. , Clearances, side , rear , min. flue dia. Total ***�k****�c�t*****�Y**�t*�c*�k�t****�Yic******&�t�t*#�*#*•4{;+:h-!;_k;kir:F:!��*iric�c�ic�icxxyc*�i�tic�t�c*� VENTILATION $5 . 00 each exhaust fans, (bath, kitchen, attic, etc. ) No. Kitchen Exhaust ducted recirculating cfm 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 CALCDLATION l. Total of above Installations or Minimum Fee ( $25. 00 ) $,-,r� �� ' 2 . State Surcharge. Add the State Building Code Division Surcharge to each permit $ . 50 3 . Postage and Handlin on all mailed-in applications, $ 1 . 50 4 . TOTAL PERMIT FEE add lir.e� 1 -� au��c $ . �J , �. � 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 Minnesota State Building Code, and certifies that all statements made on this application are complete, true and correct. � Applicant �ff''i�,i,.,,�,p.� f-- Date �C� •�i.� rS.� * 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 charge for postage and handling. _ HOUSE HEaTING TEST RECORD , ADDRESS ' ` � � �� APT. FLOOR CITY SUBURB ��'�'�-�� OCCUPANT �- � OWNER HEAT LO55 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 �' � GAS D SIGN CONVER `� ` �'! i MAKE MAKE OF BURNER ==.� C��} ' Model � � , d Model ` _ � Sxial Max. BTU Rating INPUT l �S L�O C' MAKE OF FURNACE ' � Model _ i �',��\� _ .,.,, .. CONTROLS � � ��>t�'r�� _ , �- �.��_ �, � -- ... THERMOSTAT �, N; Heat Plug t � Vent Size k " -y ^� �_.. Volve /-`� ' KIND OF LINER SIZE NONE Limit ��' Draft Hood Regularor Limit $etting l�� , Filters $ize�l�r� � Number � Fan Setting Chimney Location Inside �^ Outside Pilot Type L Chimney Construction � �� `�� r Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing Draft �'CJ`�t�e Test Tag `— L.W. Cut Off Door Pressure Lighting Inst. �' Pressure -� Percent C0� "'"' �' Date Tested �' — Input CFH �!� .S Percent OZ Company Testing 'Stack Temp. � � Percent CO Name of Tester � Form 235