HomeMy WebLinkAbout1991-004089 - mechanical �F{I��IIT
CITY OF ORONO '� PERMIT TYPE: �:,�:;�:r�H����:;,�
1335 Brown Rd. South • P.O. Box 66 Permit Number: ��a:��t��_:_�
Crystal Bay, Minnesota 55323 Date Issued: �r�°;'c;r:.;��;�
(612) 473-7357
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APPLICANUPERMITEE SIGNATURE ISSUED BY:SIGNATURE C�(r
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CITY OF ORONO
APPLICATION FOR MECHANICAL PERMIT
GENL�RAT. INFORMATI ON
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 CARD 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.
5. H�use ueating T�st Reccrd mus� be submitte3 Y�efore fir�a�.
INSTRIICTIONS Complete aIl items on this application. Compute the permit fee.
Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.
If you have questions, ca21 473-7357.
WALK-IN PERMITS apply at City Offices, 1335 South Brown Road (Cty. Rd 146)
MAIL-IN PERMITS enciose fee - Mail to: P.O. Box 66, Crystal Bay, MN 55323
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Please check one: New Addition Repair j� Replace
.
JOB SITE: �� p � Zip:
Cwr.er' s i�a:n�: Te��pr.or.e N�:nber:
Ma�].iLTlg Ad.c��,'Pc� �� �r� __ ri;�- �y..
"1 Y•
Contractor' s Name: F= ' � - a . ' Telephone Number:
Mailing Address ' City: Zip:
*************************�*********� *******************************************
MINIMUM FEE ( $30. 00 per project)
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SYSTEM DESCRIPTION: $15. 00 each unit
Heating Systems: �
Quantity:
��Iake: f ,C �r �ZL
Model: �
Fuel:
Flue Size: � ��
Input BTUs : f�,�. Qp�i
Output BTUs: T
CFM:
********************************************************************************
Cooling Systems:
Quantity:
Make:
Model:
Tons:
H.Power:
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� •
*WOOD BURNING _EQUIPMENT $15. 00 each unit
Wood stove with flue
Wood combination or add-on unit
Factory fireplace with flue
. Factor Fireplace (s) freestanding built-in
' Wood Stove (s) franklin, other
__ _ _ ._.. . __ .. _ . _
BrandName Model No.
_ .. _ .. _ . . --
Mfgr' s Min. , Clearances, side , rear
, min. f lue dia.
Total
****************************************�**************************************
VENTII�ATION $15. 00 each project
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. Other Fans: LccaLions c=„
Total
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FOEL. _STORAGE (must be approved by fire marshal)
�C>.��'= � Permanent/Temporary
Fuel oil, gallons underground inside outside
LP Gas, gallons
Other Gas opening
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GAS LINE INSPECTION
High/Low Pressure $15.00
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���iIT �1sI3 CAY.CULATIOIS
i. i0i.ai �i a�G"vc ii18�`.uiiativl'iS Oi r�-�izaiuiaiu i�SE {_Y�Q•��•!_ Y �>,Qp
2. State Surcharc�e. Add the State Building Code Division
Surcharge to ea'ch permit $ .50
;; 3. Postage and Handlinq on all mailed-in applications, $ .. 1.50
4. TOTAL PERMIT FEE add Iines 1-3 above $. _ � �,c�>
� The undersigned hereby applies to the City of issuance of a Mechanical Permit
agrees to do al I work in strict accordance with the ordinances of the City anc
the regulations of the Minnesota State Bui lding Code, and certif ies that a 1 =
statements made on this application are complete, true and correct.
Applicant's Signature:�_:J ` ' Date:_ . //-��-y/
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SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB NO. ��,r���
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 • (612) 881-9000 TEST RECORD
-7 /- (� (� i 1`
ADDRESS A 7(� `_�lS CO II�� /f- `-� � CITY U �L%�1 �
f � S—L�,
OCCUPANT � OWNER JM 4� , � O
SOLD BY �c� �I G t.a)r C �- INSTALLED BY C P �G L.J I C�'l_.,r
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MAKE � e h n o -)- \ �v10DEL l� �d vi�/l' C -�� f r ��
SERIAL NO. ��9 r �� I� �� � � INPUT I� .f`OU n
P -�r�r-,
�J � � ��
THERMOSTAT llU�Q j��e �� VENT SIZE �
VALVE r�/ ._) / ' TYPE OF LINER C/4 S� /?
LIMIT S T ��G� LINER SIZE
LIMIT SETTING � FILTERS: SIZE_ �AG CC Zj�t� C' NUMBER f
FAN SETTING �J'�'�� WIRING �""
PILOT TYPE L r e.G'�l0�"I/ C._ TEST TAG �
IGNITION MODEL K S LIGHTWG INST. �
PILOT TIMING � /'S �C'�`� q _
�,W • C ` DATE TESTED T / _
PRESSURE �'� PERCENT CO2 S -(
INPUT CFH l� PERCENT Oz (�� COMPANY TESTING e C` W!G v`-'
STACK TEMP. ���+ PERCENT CO NQ'�e- NAME OF TESTER
FORM 235(REV.11/89) FORM DISTRIBU ION: WHITE COPV-JOB FILE VELLOW COPY-CITV