HomeMy WebLinkAbout2005-P08784 - mechanical PERMIT
C( � " OF ORONO
Permit Number:
2750 I�elley Parkway- PO Box 66 Po8784
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued:
5/31/2005
SITE ADDRESS: 2967 Casco Point Rd Unit#
Wayzata,MN 55391
PID: 20-117-23-31-0064
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: $ 195.94 Valuation: $ 15,675.00
State Surcharge Fee: $ 7.84
TOTAL FEE: $ 203.78
APPLICANT: Palo Companies, Inc. OWNER: Mr. &Mrs.Rozeboom
14208 Hwy 12 SW 2967 Casco Pt Rd
Cakato,MN 55321 Wayzata MN 55391
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.
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APPLICAN ERMITEE SIGNATURE SUED BY SIGNATURE
Copies: 1-File(Signatures Required), l-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
+ FOR CITY USE ONLY
0 City of Orono
• � � � P.O.Box 66 Date Received: Permit#
��;;,.,,,, � 2750 Kelley Parkway
i` Crystal Bay,MN 55323 Approved By: Amount$:
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CITY OF ORONO —MECHANICAL PERMIT
(All Commercial penrits must be approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical pemuts by mail or in person at the City offices. Applications will
be reviewed and a pernut will be issued witlun two working days.
2. Pernut cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CAItD IS POSTED ON THE JOB SITE.
3. Mechanical Desi�ns—Complete calculations, details and specifications are required for each
heating, ventilation,hunudification-dehunudification, 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 pernut must be
obtained.
5. All work must be done in accordance with tl�e Uniforni 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/ Owner Information:
Site Address: �`���7 ��"�<<� ��'''����� �"��
Owner: T=� �'z����-����� Mailing Address: �'�� C�='``' ��T '-`���.
City: t,J��z;��-r�� Zip:
Home Phone: Altei�late Phone: ���- �� �3 :� �����
Contractor Infonnation:
n
Contractor: jr+�-- �",��-%ar��-, /,`-c_ ContactPerson: �`��� a->`-ti"� /��-� i�{��-�
Address: �1��� �-�S i-�y 7=�5�-�-- State Bond#:
City: �' �'�>� Zip:���' Expiration Date:
Phone: 3��e���-��3�3 AlternatePhone: 3�� ��``�� �`'��
❑ Insurance—Current:
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MECHANICAL SYSTEMS BE1NG 1NSTALLED �
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HEATING SYSTEMS ,
Quantity: �
Make: ��'�- �-'� x
ModeL• Cti C/r��,�� �3�3_ c��
Fuel: ��rri-n-�
Flue Size: � �°�
Input BTUs: 7� ,�^-�-�
Output BTUs: GS S�c
CFM: /?��`
COOLING SYSTEMS
Quantity: �
Make: ��'���ri
Model: x� 2 i - �z y_ z:��
Tons: 'z
H. Power
FIREPLACES
❑ Gas Factory Fireplace
❑ Wood Burning Fireplace
❑ Wood Stove
❑ Wood Stove With Flue
Brand Name: Nlodel No.:
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath E�Iaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
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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 elechical 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 conh-actor.
Skip next section, if this applies; Cost of Pernut $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $
PERMIT FEE CALCULATION(S) —JOBS OVER $500.00
If above does not apply; follow guidelines below:
1. CONTRACT PRICE * is 1.25%of conh�act price with a(Minimum Fee of�35.00)
/SC-��� x A125 �
(�ontract price) (minimum�35.00)
2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x.0005 $
(contract pricc) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amoimt 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 or contract price for pe�nut fee putposes. In the event that there is a dispute on the
amount of the job cost, the City may request the subnussion 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 staten7ents made on this application are complete, true and
correct.
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Applicant's Signature: \� �= �� `"`i�z���� Date: ����'`�
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