HomeMy WebLinkAbout1997-008779 - furnace � PERMIT
` CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 - - � � � '
Permit Number: - "�''�=�='-��'`-�
Crystal Bay, Minnesota 55323 - - - -
(612)473-7357 Date Issued:
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPUCANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE
..
CITY OF ORONO APPLICATION FOR MECHANI �ERMI'T
Box 66 (2750 Kelley Parkway) ��C�� ���
Crystal Bay, MN 55323 � 1 � 1yy i
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GENERAL INFORMATION
L You may apply for mechanical permits by mail or in person at the City office��;.;"'Ap`plications will be
reviewed and a permit will be issued within 2 working days.
2. Permit 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, K
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 ohtained.
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 siibmitted 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, call 473-7357.
Please dleck one: New Addition Repair � Replace
�' Residential Commercial
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.�OB SI1'E:_ —,� � l-� d��, �,;_:�/ f;� �,.,rz S��' `�, -L,; Zip:
Owner's N.:�e���� E� ��,i_��';,_�a Z. TelephoneNumber:
Mailing Address: , , City: 'Lip:
Contractor'sName: TelephoneNumber:
MailingAddress: 3260GORHAMAvE_ ��NG City: Zip:
-�T.LOUIS PARK,MN 55426
SYSTEM DESCRIPTION A�Es s2s-s�s� sERvicE s2s-ao11
HEATING SYSTEMS
Quantity: (
Make: 9 •�
Model: '�' � �
Fuel: ��11, ��:�
�
Flue Size:
Input BTUs: �����r�� _
Output BTUs: _
CFM:
COOLING SYSTEMS '
Quantity: '
s
Make:
Model: '
�
Tons:
H. Power
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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.
VENTILATION
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. Other Fans: Locations cfm
FUEL STORAGE (MUST �E APPP.CVED 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)
x :,,� 7C;� , — x .0125 $ .;�� �^:�`
(contract price) �
2. State Surchar�e. ** Add the State Building Code Division
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Surcharge to each permit. :�a:`",.:� �''� � x .0005 $ � ` � `T
or $.50, whichever is greater (contract price)
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3. Posta�e and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT PEE (Add lines 1-3 above) $ � ). (c- �
* CONTRACT PRICE or JOB COST means the actual or estimated 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 S"I'ATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is
grea[er. For valuations over $1,000,000 call the Department of Inspectional Services for the price.
The undersigned hereb� appl i�s to the City for issuance of a Mechanical Permit, agrees to do
all work in strict accurc!ance with the ordinances of the City and the regulations of the Minnesota
5tate Building Code, and certifies that all statements made on this application are complete, true �
and correct.
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Applicant's Signature: ���� //��� %��" C�' �� � rC� Date: ,�-�� �
Approved By: Date: �� �1
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i� t:�11:(, _
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; � a.�.tt v t.. �ottructioo No.
Guide j��
t:�ndowi ~ �� Doors Reference Out.Wall fnt.WaQ Ceilin; Roof Floor Kind y�q��
�es—No i� es o 19._
Fl•I Room �Q�, 3g w�a�h � Height Fl.� Room L,eoa� Widch Neeafit
Window� and Doors—Crackage and Area ,e,u�Q��y�Qj, w��� and Doors---Cracka�e and Area
�vlatn H�I�et No.o( Lln�al tt. Ana
-�o. o!pan• of Dan• II�AI� of eraek �p.It. WIdIA H�I�St No.oI Lln�a�!t Aw
Q �j No. ot p�n• of Dao• II�At• o[erack p.t�
'�� 0 Z- O�.
,�� - �3,� �,
�`� �'�' f , ��. 8'
a ;�,"' �c -�
�6, �?� O Coef. Btu Coef. Btn
�nhltntion
':lats �It�ltrttioo
�zp.wall ��
�et'exp.wal) Fsp.wall
`n t. wa II Net ezp.wa11
eiling Ia�wall
foor Ceiling
'- Floor
��:�! S!�. .--- -,.���L, ' `.r JTotal gtn. .
'.�quired:q. h. E.DR or�q•in�. W.A.Leader srea
Reqnind.y. h.E.DR or�q. in..WA Le�der ara
Fl.) � R�o�om l.ea�tb Width Heisht Fl.I Room I Leay�tl� WidtL liei�t
W�ndow� and Doors--Cracka�e and Area Windows and Doon---Craekase and Atea
wia�e x•�rc H..et � w�
�'' °�a�• e[aw� Il�\ta o[eratt p:t4 WIdtA HN�\t a o[ Ll�al[� Ana
/ � / / No. of pan� ot pan� Ilibv et erack p.tt
G� , 1�- 3 2-0;�
� 2 2�,
'� 2 � D l5,o
x'� � � 5 C«f. Btu
hitration �
InblUation
'au
�p.wau ��
Fap.waU
-c e:p.wall Net ezp.wall
t. wall
.iling 1nt.w�ll
- Ceiling
oor
Floor
��I Btu. -- Total Btu.
-�uired sq. f� ED.R. o�sq. in�. W.A.t,ader a�e� Rcqu;�ed w• h.ED.R.or�q. ins.WA. Leade�ans
;1.� Room �Len�_" Width Height tn ?.,�oae i i.en�tn widc� H ' ht
��Vindows and Doors--Gaeka�l.�Od At'!a'�` _ - �r �:�: ., �� � �
w�a�n H�Il4t Na ac a �, wr.. ` "Windowt.�nd Doors—Craeiu�e and Area
or pan• ot wa• Il�et� ot aHak M.tL �h .ts►e Na et w■wl t4 wrw
Na et v�.• et paN U�4ta ot enak N.tt
l �f�� �1� 2 l o � l5 p .
Z �1 � l � o I6
Coef. Btu Coef Btn
�Itration `��O ,3 (nfiltration
�" 7 SO Glau
r�. wall
Eup.wall
< <xp. waU �2C� 1 o I Z O 3 Net exp.wal!
�. wall lA�w�ll
ling � p Ci gO' Ctl�tng
or `��g (� �j Floor
��� B�°' Total Btu.
��ired �q. ft. ED.R. or �q. ia�. WA. L,ead�r area �p Z Requircd.y. ft. E.D.R. or
tQ. in�. Q/A. l.eader area
-;� `� ��a`i�
H. USE H�ATING TEST RECORD ��
ADDRESS �� �"�r y �'�ir'� � APT. ,F OOR CI SUBURB ����v
OCCUPANT � OWNER `��jr���~
HEAT LOSS DATE HTG. INST. �DC "' �
SOLD BY INSTALLED BY
El�ctrical Work By Gos Lin• By S���
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
G,AS DESIGN CONVERSION
MAKE ��N�� MAKE OF BURNER '���
Mod.l � -- 1 ' Mod.l
S�rial t =� U Mo:. BTU Rotiny
INPUT �� MAKE OF FURNACE
Mod•I _ �
� / f CONTROLS ,__.�., ��( G���t `
THERMOSTAT V`l H•ot Pluq V�nt Si:�_
Valv• �' ' �-"2 KIND OF LINER SIZE Nj�NE
Limit ,.S /��"".�G Drah Hood /�G�Z R.��leror ��� k�l'��Z�'
���.
Limit S�ttinq Filt�rs Si:• Numb�r
Fan S�ttinp f��� ` � O�imn�y Location (esid� � Outsid•
Pilot Typ� � ' �'a`�1� U�imn�y Constnietion � �
Pilor Mak• /
Pilor Mod�l � 3� Smok� Bomb Wirinq �� �
S�� 0.oft �
Pilot TiminQ 1 T�st Taq
L.W, Cut Off �, �— Dow Pr�asw� Li htino (nst. �
Pr�ssur� �' P�re�nt CO ���` Oot� T�st�d �— �— `
2
Input CFH � �� P�re�nf 0 ` Compony T�Ninq Q ' �
� �
Stack T•mp. ��ys P•re.nr CO a`v NonN oF T•sf.r "�