HomeMy WebLinkAbout2012-00499- cooling systems CITY OF ORONO �z 0 1 Z - 0 0 4 9 9 *
� 2750 KELLEY PARKWAY DATE ISSUED: 06/07/2012
� ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 4265 CHIPPEWA LA
PIN : 31-118-23-42-0019
LEGAL DESC : UNPLATTED
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : COOLING SYSTEMS
VALUATION : $ 1,999.00
NOTE: 1 YORK 1.5 TONS
APPLICANT MECHANICAL 50.00
HIGH ROAD HEATING&COOLING CO STATE SURCHARGE MECH(VALUAT[ON) 1.00
6650 WINDFIELD CIRCLE N
ROCKFORD, MN 55373- MAIL-IN FEE 2.00
(763)477-3331 TOTAL 53.00
PA[D WITH CC# 6595
OWNER
MCCAFFREY, THOMAS& KATHLEEN
4265 CHIPPEWA LA
MAPLE PLAIN, MN 55359-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separa[e
permits. All provisions of laws and ordinances governing 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
revoked at any time for due cause.
�1 C.vY-L U' �/l'L l l
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Applicant ermitee Signature Date Issued By ignature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
06/06/2612 10:44 7634773338 HIGH ROAD HEAT COOL PAGE 02/05
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i+OR(_Ti'v�iRF ONI Y
C' oFOron
`, � $'�� r.o,IBox66 �I DateReceived; Pemiit�
� ��t ., � 2759 Keliey Parkway
j � `�,�;"� Crysk�i Aay� 55323 APPt'�'�'�QY� Amo�uR S:
I � %�y� Phot�e l952)2a Fax(952)249-d616
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I CiTY OF ORONO—MEC�iA1VICAL PERNII'T '
I (All Com roial pe '�s must be opproved by the Building Offioial or Inspeclot and/or Fire Mazshall)
i
! GENERAL INF �ZMAT�ON �
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� 1_ Yau may apply for m�Chanic.al pe,mitc hy ma.il nr in�ersnn at the City offices. Applieations�will
� bc rcviewe and a per�►it will t,e issued within twa working days.
i Z. Pcrmit card�will t�s�c�t by retum mail after a revicw is eompleted. PCRMITS/�RE NOT
I VALID UN�L YO RECEIV�A PERMIT. WORK MUST NU'I'��CIN UNTIL THE
PERMIT CARD I3 '� D ON TAE JOS SITE. i
j I 3- echanical D Si ns�Complcte c;aleulations,details and specifications arc required for e�ch�
i � IiarLi►►g, vi:i Lilalion,hl�midifcatio��-dehumidifcation,and air condiLioning insttillation inclu�ing
' ; I heat loss/h gain�l�Culation,design tcmperatures,equipment ratings end identification as tb
' ! type,manut'acturer anb modcl. Da1.s shsill be ptesented on form provided.
4. Wheil any n�Cw Ctmsti�ction crr rcmudel;ng i�invulv�l,a�r�,arx�e buililing peroiit must Fic
; i obtained. �
I 5_ All work m t be don in acco[dance with the Uniform Mechanical CodclStaLe Buiiding Code
; requircmCnt�.
i i G. All work m�st be ins ec[ed(rough-in and final). Call(952)Z49-460U.
� (24�48 hou�notice r�c�uired)
, � 7. House Heat�ng Tesc Riecord must be submitted bcforc linal. ,
TYPE OF PERMIT �
� Check All That A 1 i
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� ❑� Iiesidential ❑(.cimmcfcial(ApptOval Kequired)
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❑Ncw ❑A dition�l n Rcpairs ❑Replace
Job 5ite/Owner Ynformafion:
� srte�,aa�s: 4,�65 �hippewa Lane �
Owner:TOfI'1 PIIICC�ff@f�/ Mailing Address: 4265 Chippewa Lane
� ; �1�,; Mapl� Plai� Z;p: 55359 �
; ;
Home Phane: Altemaae Phone: '
Contractor Lnforr�ation: ;
i i ;
' I Hieh Road Hsa��g����e�. Robin Joh n�on
� Contractor: 1 L Contact Person:
� I '
; j ,A,ddress: 6�50 Wnfi�eld Circle N ���Bo�d�: 07770666319�443
� �
! Rb��o�a, MN 55373 05/10/14
City: Zip: Expi�ation Date: '
Phone: ( 63) 4�7-3331 Altcmate Phone:
' ❑ Tnsurance—Cuzrenr Auto Owner�S
� 1
66/06/2612 10:44 7634773338 HIGH ROAD HEAT COOL PAGE 03105
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' I Note:All Geotherahal Systeins will now require a Site Plan Rc.R .eview 1ry�ur Ruilding Official.
i ����l I I
� j IS THIS GEOT�IERM.AL7 ❑Yes ❑N No !
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; ; HEATING SYSTEMS j
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�
I Quantity: __ _- !
I �
� � Make: �
' M.odel: I
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' � I ruel:
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Flue Size: ,
� � Input BNs: '
, �
�
,
! (hrtput BT[3s: _ _ 1_ _
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CFM: '
' COOLING 5Y5TE S �
I �
; Quan[iry_
. M��: jYORI�
�
' Model: ��D18�541S1
Tons: '5
• ' H.Power ��_ �
F1RE�LA,CES '
❑ C Factory ireplace BrandName:
� ; a Wt�od Bami�g Fircpiacc ;
Wdod Srovc Model No.:
❑ Wdod Strnc ith Fluc/Masonry
I
i � vrNTaz.ATro�v
i I ❑ No Kitchen Exhaust duM recirrulating cfm
i ❑ No� _� Bath Cxhaust(must have duct outside) dm
; i ❑ Nol ____� Olhcr Fans: Locations �frn
; ' FUEL STORAGE as[he�rpproved by FFre MarshaU ifPropacing ta a6andon�Qnk irr place) �
❑ lns lation ❑ Rcmaval
Fu�l Oil: gallons ❑ Underground []Insidc ❑Oubic�e
� LA Ga,t: _�gallans �
er: �
4A5 411V�UNLY �
� Ou door Gril � Other/List What&Where:r____�,
2
06/06/2012 10: 44 7634773338 HIGH ROAD HEAT COOL PAGE 64/05
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! [] Ye�,this se�on aPPlies !
� ; ; Thc teplaccment af�R psidcnl��l_Gxturo ar ap iancc that mncis all three of thc fnllowin�requitemen�s:
6�a'i. �
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1, e.g t requirc modifGation to electrical or gas scrvice•
! j 2, kl�s a t st f 3500.00 or les5;ox�ludinrt thc cost of thc fixturc or nppliances and
, I 3. Is imp�oved,inst�alled�r replaced by the homernvttec or licensed contractor.
i � Skip n�sectio�,if this applies; Cost pf Pcrmi► $ ]5.
; � State Surchargc ���
Mail-In Fee(If Applicable) $ 2.Ob
i i TotAI PermiC k�ce �_ i
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� ' ItMIT EE CA1-CULi4TION S .,-JOBS OV"E�R-$�00.0(� : ...,;::::'. :, `:��;:::.:
, !f above does not a�p�y;follo�v gUidelines below: ;
� j �, N� T E "is J.25%of cvntract pcicc with a(Minimum Fee of 550.00) '
; I � � x.0]25$����-
(wntr;tct price) (minimum S5U-110)
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2. TA E RG 'E ��j �
' ' "{ �� �x.0005 $ C v - -.
� � (com�uct pri�)
�
! I 2.00
3. POST G[�& NDLINCr(Anly on Mail-In Applications) $
� ! 4. TOT PER FEE(Add i.incs 1-3 Above) $ ' � ,
! ■ * CONTRAC7'PRIC� r JOB C:U5�1' mean5 A7e ac�ual ur��tLiaatcd dollar nmount chRrged for the:
� permittc,d wor ineludin macerials,labor,proFc,and o[her fixed costs. It is thc amount Lo be�chasged
to thc custom�for the�vock dona l.f any material,equipmcn[, fabor or installations ate fum�shed by
the owlner, tcn�ant or an�other patly,thc reasonable markct value of yuc:h itcros n,usi bc adddd to thc
estimated cos or conttflct price for pcnmit fee purposcs. In thc event that there is a dispute on the
; amoimt nf�], jab cost�the City may request thc submission of a signed oopy of the actual bonbscti.
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I ;` C�i.All'�11C���RM1T`A�'PT:IC�►:'�'�ON�AGREE�El'�l'�' : � � � ,�;
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� to do all
I The ur�dctsigne hereby plies to the City for issuance of a Mechanical Penmit, agrecs .
; � work itt striet a eordanc� with the crrcli�.�a�ces of thc City and the regulations of th� fitaYe of
! ` Minnesata, and certifies tbat all statements made on this application are complete, true and
c.�rrect. �
A ticarit's Si atu � � -���L Date:. ��t�L�
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