HomeMy WebLinkAbout1993-005455 - furnace PEI�MIT
CITY OF ORONO PERMIT TYPE:
2750 Kelle Parkwa • P.O. Box 815 �' ' ���.-�r';;j j i;�j
Y Y Permit Number: t:,�;�,�+.��
Orono, Minnesota 55356-0815
(612) 473-7357 Date Issued: _ `,,, ;��;.^�
s i;-;;'.
SITE ADDRESS:
� i€=, ;_�`l1-+�;;y i_:�-i'-��=;� C=?�°
i '��{�
- . l� . . . . . _. _.—i r �w =_—�.i —:i i,:-t�.
I DESCRIPTION:
�=���°C����:E
�. �"s�H ' I�i.jij _;`•���_�!��'I'•>> ��:'•�� l��i-�l��_�i1i���_ ?.3t-i��� �':f�t�.� �'ii:1'jra,�'1�
l�t; )E;! -"=r_' i4�: i —'1
F�_.�.. —— -- _. _��'`�)! _�_ � t 1�_7 i�
3.!;.�i_� �`i = _'7:!
_�_iri:
IREMARKS: _ . _
_ _ _ -
I FEE SUMMARY:
E:��:;�,t 1�=:�:t�:�� i;�; - ��, .
l.�Ji.,-!�F=+ �Yt;,-�+ Y•'� . f�:) ����`f i' 314t ll S . • '(i
;-. � � : � •:' - -
. . � _ a
�st�"€'rf:�.ti''3c' _______ �i i:�. � tif,L:! ��c' . _ , .f_,t
;_;�}r,}.;;i.�? '_N� i sr
CONTRACTOR: - �:���:�� ?��;�t. - OWNER:
—,T ;if Ti~ �' ;_' .I# — _ —°:i'Y�Cr� }:�'. `-; � ��. r�ti,;
_ • H`...JH1',� I'1 t -� t; i-i t. _3 - -— - - - �`€�_..:I-i,�: 's ��� i -_t�: :�1
+.{->.�_� LHf'•.G _ Fi7 � 1 ,t F';� C.���J� G.f��•L�'�� 1 t-�
�'3����i��i''i�`!_�_ _ • �>e�y� CC 1 _ _ i il'�'"',,�� t:F CC•__;
� � - 1 T:-: ; a..i)�=': ,_,�!_'!1, I !�: _��.
. _. ..._.. . _..._. . ___.- {.k'�'�.):1 I:_�--:_:?(i:E
�—' �{.;i�r:,::_�i i.`;•.�}"_;=5 .�i�" i"G � s.ii;i_:� — — �:`�/ _ ;i�iY.i j L'�." � j :t;� � „?�'t:���'__
t9�1__ s_�:a��z_;:-�; .7 3i:` �'���?�_�� �`.�_-,�_5__�' _ :'L:. .E €;��-�_�_ .: 3 � '•_i �''(-?;•._ !�._ . .`��_ S.# t'4:�'�._ ��....�? I `_
�-� r.r
�_a��C:.•T;_'•'_,;� .+.�f�_ .j�`;�.�"_°_, , _. :i3«> r�`•;�.f �:_.��.. . i`" �.;�..r.�.. . i _:; :i�.:�i :;tl'__ cs;� i -�-� ..a � _� "{ ''r' 3 '�-
L..L:.t.: 1:__ h� . {�i' � �t 4"' �. ��. z . . i—iL_ ..i
�—'i�;-i;�.i?.' s_�r:zJ�!`;:-�!'�?'_���_� -i:'I?�.' : �;-i�� i_t�- ;j�j�.i?�•;�'�:s..' � � �=#_i�;'s_t!'��'�.� '•_�.'`:J�: Fz.=`••.<}`9 3 t�:i:I's?�I`�i'� . I
� J
���� y
APPUCANT/PERMtTEE SIGNATURE ISSUED BY:SIGNATURE �jyc)
' M�� -..�.��
, ` � _ ;�
. < ... _ .
CITY OF ORONO APPLICATION FOR MECHAI�ICAL PERNII'T
Box 66 (2750 Kelley Parkway) ���p� 2`� ��
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for mechanical permits 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 return mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PER114�IT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Mechanical DesiQns - 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. Identification of and specifications for water heating equipment
shall also be provided.
4. 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 final). 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 pernut fee. Sign and date the certification.
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 473-7357.
Please check one: New Addition Repair 4,' Replace
Residential Commercial
JOB SITE: � ,A,.�,� � Zip; _ i
Owner'sName: � i�.' . ��;� �,�'�r�� . �,l,;r �� TelephoneNumber: � � ; - 5�����
Mailing Address: ; :� � ,�,,�,,,., 6 l.�_ , City: ,,, ; .: Zip: . ,
Contractor'sName: �,���,��, eur nNr,�OA�R[`,�f�1�(fiONi��GC� TelephoneNumber:
MailingAddress: .:..��^rEs b a�:tc�:�REET City: Zip:
MWNEAPO . 'ts
SYSTEM DESCRIPTION PH�� �r�
HEATING SYSTEMS
Quantity:
Make: '
Model:
FueL•
� Flue Size:
Input BTUS: � < �
Output BTUs: r � �
CFM:
COOLING SYSTEMS .
Quantity:
Make:
Model:
Tons:
H. Power
,y
��5
' l . .
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 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)
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 ($3_5.00)
� x 1.25 $ �
(contract price)
2. State Surchar� ** Add the State Building Code Division
Surcharge to each permit. � x .0005 $ �, �
(contract price)
3. Posta�e and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ -;•� ., ;
* CONTRACT PRICE or JOB COST cneans tiie actual or estimated dollar amount charged for the pemutted
work including materials, labor, profit, and other fixed costs. It is the arr.ount 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 pernvt 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 certifie�hat all statements made on this application are complete, true
and correct. �
Applicant's Signature: 1 �-' Date:
Approved By: Date: � ,3
.
` ' � � RESIDENTIAL LOAD CALCULATION
. _ �,
Purchaser
���� �� �;'�-�� Sales Rep �� � Date �y �� '��1 -�
Address �� 'b '�J-���l C�J�°-
Sq I't gross wall
Running walls below grade: .y�� x �(l't wall llt) _ �� el.ow rade
_ �� Sq FL windows and
doors below rade
, - � et wall below
rade
•N _ �r ���Sq ['t gross wall
Running walls above grade : �x � (�t wall tit)- �bove c�rade (lst floor)
� (lst rloor)
Sq Ft gross wall
Running walls above grade: x (Ft wall 1it) = <�bove r��de 2nd floor
(2nd ['loor) Sq L•'t gross wall
-►-
_ /,�L Total gross Sq I't
- above rade �
�(� Sq I'L windows and
- �"�7�"" door.s above rade
_ '�� Net wall above
rade
Windows & Doors 3 �� Sq I'l: x � 11TM = �S yDG 13TUH
Inf. (w&d x 1 . 3) �.� Sq I't x 3S • IITM = � �SS I3TUH
Net wall below /
grade /�� Sq I't x � I1TM = ��'30 BTUH
gradcall above '� S rL x l IITM = �5��� •
�O q � �BTUH
�xposed Ceiling ���'i. Sq I'L x � I-ITM = 3ro51- BTUH
�xposed Cloor ��J� Sq rt x � !-ITM = (p5�. BTUH
_ ( 6 BTU TOTAL
Windows & Doors �� Ceilings & Floors
�lo � � ��-G,
51 �� �S
�v y,�-
�
bS'
3'��-
DATE TIME
CITY OF ORONO CALLED IN 9 /y3
INSPECTION NOTICE SCHEDULED ���s� /D : c�v
PERMIT NO.-�'�S 5 COMPLETED �I �j
ADDRESS � /-� �
OWNER�=,��,��1� CONTR.
TELEPHONE NO. '7"7 3 - r��C� SL
� DESCRIPTION �.n� �tif' -�,z,��iu•
� 01 FOOTING 11 MECHANICA� 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
O
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 NAL 13 METER SET/TURN ON 77 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
v 07 UEMO—FINAL 27 SEPTIC MAINT. 21 COMP�AINT
� 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
v 10 PLUM8ING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
� '/
� 5 L.S �( G � D[�
�
J
O
�
�
O
�
W
�
Q
�
Z
W
�
W
�
j
d
� �WORK SATISFACTORY:PROCEED �PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED C; ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. , pH0T0 TAKEN
INSPECTOR WILL RETURN
CJ STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnerlContractor si
Inspector. � -�
White Copyllnspector's File Canary CopylSite Notice
. ..!Y . ... . . ..
410 W. LAKE ST. 1072 PAYNE AVE.
MINNEAPOLIS, MN 55408-2998 ST. PAUL, MN 55101-3892
612/824-2656 HEATING AND AIR CONDITIONING C0. 612/772-2449
/ "cServing The Twin Cifies Since I930' y
��-t�� ORSAT TEST RECORD nCT �. $
����
ADDRESS CITY
OCCUPANT OWNER
DATE HTG. INST. INSTALLED BY ----
GAS L I N E BY i L�''�------
i �>��--.� ,� '
TYPE OF HEAT: GA FA HW STEAM SPACE HTR. UNIT HTR. OTHEf�'"` ��'�
GAS DESIGN CONVERSION
MAKE MAKE OF BURNER
MODEL � MODEL
SERIAL MAX. BTU RATING �
INPUT MAKE OF FURNAGE
CONTROLS MODEL
THERMOSTAT HEAT PLUG , VENT SIZE
VALVE KIND OF LINER SIZE NONE
LIMIT DRAFT HOOD RE�ULATOR
LIMIT SETTING CHIMNEY CONSTRUCTION
FAN SETTING DRAFT TEST TAG
PILOT TYPE LIGHTING TNST.
PILOT M.AKE
PILOT MODEL
PILOT TIMING r-
PRESSURE PERCENT CO2 DATE TESTED
INPUT CFH PERCENT 02
STACK TEMP. PERCENT CO NAME OF TESTER