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Home My WebLink About2013-01003 - mechanical � � CITY OF ORONO * 2 0 1 3 - 0 1 0 PJ 3 * 2750 KELLEY PARKWAY DATE ISSUED: 09/26/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : ]06 CHEVY CHASE DR PIN : 36-118-23-41-0033 LEGAL DESC : HILL O'WAY MANOR : LOT 028 BLOCK 001 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : MECHANICAL-MULTIPLE VALUATION : $ 3,700.00 NOTG: QUADRA-WOOD STOVE-2100 MILLENNIUM APPLICANT MECHANICAL 50.00 COUNTRYSIDE HEATING& COOLING STATE SURCHARGE MECH (VALUATION) 1.85 65l 1 HWY 12 MAPLE PLAIN, MN 55359 TOTAL 51.85 (763)479-1600 PAID WITH CC# 9617 OWNER JOHNSON, MR. & MRS. 106 CHEVY CHASE DR WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work fbr which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State[3uilding Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be rev ked at any time for due cause. � � � /.Z(o� / icant Permitee ign ure Date Issued y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. From:COUNTRYSIDE HEATING & COOLING 763 479 2518 09/26l2013 10:21 #816 P.001/003 ' �'��- c� �.�- ��--- "Zb�.`�l� I b �o F'OR CI USE ONLY City of Orono �/ y� �O�O P.O Box66 DateRoceived� ��^��0�� J Perwit# 2750$cliey Parkway CkystalBay,MN55323 ApprovedBy AmountS: �j5 Phoae(952)249-4600 Fa�c{952)249-4616 /� 0 -� �. ! ti � ��'kfsxoaE�' CITY OF ORONO—MECHANICAL PERMIT (All Commercial pennits mustbe approvedby the Building Of2ic�al orInspector ancUor Fire MarshaU) GENERAL INFORMATION 1. You may apply for mechanical peitnits by mail or in person ai the Ciry offices. Applications will be reviewed and a perm it will be issued within two working days. 2. Petmit cards will be sent by return mai]atter areview is completed. PERMITS ARENOT VALID UNTTL YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT C.4RD IS POSTED ON TT3E JOB SITE. 3. Mechanical llesiaas—Complete calculations,details and spec�cations are reqvired for each heafing,ventilation,humidif`ication-dehumid�cation,and air conditioning installation including heat loss/6eaf gain calculation,design temperafures,equipment reYings and identscation as to type,manufacturer and model. Data shall be presen2ed on fonm provided. 4. When any new constrvction or remodeling is involved,a separate building petmit must be obtained. 5. All worl:must be done in accordarice with the Uniform 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 subm itted before final. TYPE OF PERMIT (G7ieck Al1 That A 1 �]Residential ❑Commercial(Approva3 Required) � ❑New �Additional ❑Repairs ❑Replace Job Site/Owner Inforniation: ' Site Address: G G�=C �i�� taS� �I` Owner: �Qtrf�t.I S �N'V��T Mailing Address: G n� �l�-�V'� ��'1�- �J F' City: ^ ?�v� Zip: ��`1 � Home Phone: / ��- �76, � C�� Alternate Phone: �Contractor Information: -�� , (�,,,,� �--� Contractor:�� c� �<<� Contact 1'erson: �_�`( �t G �l f., i Address: �� 1�� State Bond#: �� S� (� �CJ City: V��J�' C� /`� Zip��:xpu�ation Date: cG 3 � Z O/C{ Phone:7��• Lj�� 6�� Alternate Phone: � Insurance—Current:�Y�{��- �Q�oC 702� 1 ��Cc.e-d`i`� �V�-i'Q t�c;,Q�U S �/ From:COUNTRYSIDE HEATING & COOLING 763 479 2518 09l26l2013 10:21 #816 P.002/003 : �.. :`� ... . .,- r��:��.��lS��C",�_,�1+T��`�'�:E��,:��-:�� ? Note: All Geothennal Systans will now require a Site Plan&Revietiv by our Building Official. IS THIS GEOTHERII'IAL? ❑Yes ❑No HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: Input BTUs; Output BTUs: CFNI: COOLING SYSTEMS Qu�tity: Make: Model: Tons: H.Power FIREPLACE S ❑ Gas Factory Fireplace BrandName: �X�(-G(c�cU-�—i r-� � Wood Burning FQeplace �� oO �� Wood Stove Model No.: . '1!�1 I CC.(� Wood Stove with Flue/Masonry VENTILATTON ❑ No. Kitchen Exhaust duct recu-culafing cfm ❑ No. ,__ $aih Exh�st(must have duct outside) cfm ❑ No. _ Other Fans: Locations cfm FUEL ST ORAGE {Msrst bc approved by Fbc Ma�skal/ifpropostng to abandon�rnk in pincG) ❑ Tnstallation ❑ Removal Fuel Oil: gellons ❑ Underground ❑Inside ❑Outside LP Gas; gallons Other: GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List What&Where: 2 From:COUNTRYSIDE HEATING & COOLING 763 479 2518 09/26/2013 10:22 #816 P.003I003 TPERMTT.�'EE CALCULATi�N{S) � �-� � fi�- �� - `' BASED OFF-2002 STA'3'E STATUB -� � ��`� � � -- ------- � :�"�' ❑ Yes,this sedion applies The replacement of aResidential fixture or appliance thffi meets all three of the following requirements: 1. Does not requile modification to electrical or gas service. 2. Has a total cost of$500.00 or less;excludinR Yhe cost of fhe fixture or appliance:and 3. Is improved,installed or mplaced by the homeowner or licensed conYractor. Skip next section,ifthis applies; Cost of Pennit $ 15.00 State Surcharge � 5.00 Mail-In Fee{Tf Applicable) $ 2.00 Total PermitFee S �_:.PE�M�`d'��A3.C�1i�A.3'��T�, :�J3�BS��t��,(��}��,��:- If above does not apply;follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contcact price with a(Ntinimum Fee of$50.00) � ( �'� x.0125$ (contract pnct) � (minimum SSOAO) 2. STATE SURCHARGE x,Q005 $ � (contrac[pnce) 3. POSTAGE&HANDLING(Only on Mail-In Applications) � 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S fl * CONT'RACT PRICE or JOB COST means the actuai or estimaYed dollar amount che�ged for the permitted wocic including materials,labor,profd,and other fixed costs. It is the amount to be ch�ged to the cvstomer for the worlc done. If�any maYerial,equipment,labor or mstallations 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 d�at there is a dispute on tlie amount of the job cost,the City may request the submission of a signed copy of the actual rnntract. �,z' _ _�r�'• ��';s�ar�,s�'r�. �`��'��'��.�•� '��.��'` �"� �a._� 'Ihe undersigned hereby applies to the City for issuance of a Mechanical Pennit, 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 comple[e, true and correct. Applicant's Signature: �� Date: "Z —��I � 3 t DATE TIME � CITY OF ORONO CALLED IN � INSPECTION NOTICE SCHEDULED PERMIT NO. s2Gl3 ' ��G� COMPLEfED �� '� ADDRESS �6� CLl Bv y C!rc S.e ��, OWNER TELEPHONE NO. CONTRACTOR �o�-��'� s��e��. �F �ao% �S � DESCRIPTION L�/� -S�o�e- l� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � � � a �Li<S ,D�, .,.�.� �'�.��i�� .6... � /.!/r Gl �C G:�7�1 �n /O ' �J- - /� 4.�r�o� � .�� .�. b�.�_ oa..�.:.z � a G�3 - �a �r3 -- 0 � W � Q � 2 W � W 2 J � ❑WORKSATISFACTORY:PROCEED �@9JECT COMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CWERING PERMANENT ❑CORRECTUNSAFECONDITION WITHIN HOURS. �pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS. Cail forthe next inspection 24 hours in advance. (g52) 249-4600 OwnerfConVactor on site: Inspector_ White Copyllnspector's File Canary CopyfSite Notice