HomeMy WebLinkAbout1997-009610 - mech j PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66
Crystal Bay, Minnesota 55323 Permit Number:
(612) 473-7357 Date Issued:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
.
a
CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, NIN 55323
GENERAL INFORMATION
1. You may apply for mechanical pernuts by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within 2 working days.
2. Pemut cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Mechanical Designs - 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. Ideatification of and specifications for water heating equipment
shall also be provided.
a, 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 work must be inspected (rough-in and finai). Call 473-7357. 24-hour notice required.
7. 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, cail 473-7357.
Please check one: New Addition Repair �+ Replace
�j Residen i�l Commercial �
JO� SITE: � �c ','�� ' '%` U LiP'�C � �
Owner's Name: G S Telephone Number: �{ Z�(� ��
Mailing Address: `t City: j;� VY� L Zip:��,7��
Contractor'sName• TelephoneNumber: '� ��(.oZ�o
MailingAddress: . BLAINE HTG.A/C ELECT.,INC. City: Zip:
13562 CENTRAL�►VE.N.E.
SYSTEM DESCRIPTION ANOKA,MN 55304
HEATING SYSTEMS I
Quantity:
Make: ✓1 �
ModeL• ` r.,� �d'�
Fuel: ��(.lt ��Gl`'�
Flue Size:
Input BTUs: �� >�>�`�
Output BTUs: �� ul��.�
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H. Power
�� .
�v
.
� .,
WOOD BURNING EQUIPMENT
Wood stove with flue
Wood combination or add-on
Factory fireplace with flue
Factory Fireplace (s) Freestanding Masonry
Wood Stove (s) Franklin, other
Brand Name Model No.
Mfgr's Min., Clearances, side , rear , min. flue dia.
Total
VENTILATION
No. Kitchen E�aust 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)
Installation Removal
Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
�-}% 1(��' (�t�_ x .0125 $ ?�``7� �>Z,
(contract price)
2. State Surcharge. ** Add the State Building Code Division
Surcharge to each permit. ,�� 1J�� .- L.�� x .0005 $
� �..` `�
(contract price)
or $.50, whichever is greater
3. Posta�e and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) � �� � � �
* CO:`ITRACT PRICE�r TOB CrJST means the actual �r eszimated dollar amount 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 installation 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 contract price under $1,000,000 or $.50 - whichever is
greater. For valuations over $1,000,000 call the Department of Inspectional Services for the price.
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 Minnesota
State Building Code, and certifies that all statements made on this application are complete, true
and conect.
Applicant's Signature:
� Date: �� l�1
Approved By: .��� Date: l-� � ��
_�������
6��,�� HEATING HOUSE HEATING TEST RECORD
AIR CONDITIONING
AND ELECTRIC. INC.
�d�r��i�1, .;"> / p���b-g.�+,«;.:-
ADDRESS C v K'Y��,,�tl+�� �'� ppT. FLOOR CITY ., �� .:+ _° SUBURB
OCCUPANT p }
OWNER ,:F• a.- ,�.€
HEAT LOSS DATE HTG.IN3T. f(� -,�Q •'�'�
SOLD BY f � I r;��1,����,. INSTALLED BY � ' /' -
Electrical Work B_y I(�/�,"� � �'My e%ry (iat L1n�By i�
TYPE OF HEAT GA FA ''" HW STEAM_SPACE HTR._ UNR HTR._ OTHER
� / GAS DESIGN CONVERSIQH„�
MAKE � 7 G� WIAKE OF BURNER � �`'�`�'^
Modal U `�"1 C? '�' A�odd ' r'��'•
sa�iai ��3 y.sa�� Max.BTU Ratinp
INPUT �'�f,6 o U 1AAKE OF FURNACE
Model
,r CONTROLS �
THERMOSTAT �GK r..�r'a � �%`�'=" Hwt Pluy V�rN 81E� t�
Valva � �.• +�+� •P° KIND OF UNEH g�� NONE�_
Limit s4tt) D►ahHood .� Rpulator
Limit Satting /��'4 '� FIR�n 31b � X o'Z�.l�� .0 Numb�r
Fan Setting Chimn�y Location Insid�—� Outsid�
Pitot Type Chimn�y Construction l/'�"_�. •
Pilot Make ^� �
Pilot Modal �+t� Smolt�Bomb Wlrinp ''�'"""
Pilot Timing ��C� :��'� Draft Tut T�y ��
L.W.Cut Off Door Prusun Uphtinp Inst. �,:_�
Prossura -�,� ea► �A Parcmt CO, � .� Dat�Tubd +L� �ICs- ":+�" `
Input CFH P�rcmt O� _ � � ���'�; Company Tatlnp r A �e «.�
Stack Tamp. ,.� •'�,,�'" f��� Parcmt CO } a� ��'�� Nam�of T�sbr ' '*• "
Form 235