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�ERMIT
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PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 i+�'F';'I'-��_
Permit Number: j i_,.• ; _;;:_.��
Crystal Bay, Minnesota 55323 Date Issued:
(612) 473-7357
SITE ADDRESS: ,,�:_,��; �;;,..����,-:��,;�; �;�
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REMARKS:
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Ar PLICA RMITF NATURE ISSUED BY SIGNATURE
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CITY OF ORONO
APPLICATION FOR MECHANICAL PERMIT
G�RAT• INFORMATION
" 1. You may apply for mechanical permits by mail or in person at the City
offices. Mailed-in permits are subject to the postage and handling fees
shown below.
2. Permit cards will be sent by return mail the same day the application is
' received. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT
BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE.
3. When any new construction or remodeling is involved, a separate building
permit must be obtained.
4. A1 1 work must be done in accordance with State Building Code requirements.
5. All work must be inspected (rough-in and final). Cali 473-7357. 24-hour
notice required.
6. House Heating Test Record must be submitted before final.
INSTRIICTIONS 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.
, WALK-IN PERMITS apply at City Offices, 1335 South Brown Road (Cty. Rd 146)
� MAIL-IN PERMITS encZose fee - Mail to: P.O. Box 66, Crystal Bay, MN 55323
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" Please check one: New �Addition Repair Replace
JOB SITE: �/_�/� C��i�,,-�r��� :f <e, �,9�c.-�_ Zip:
Owner' s Name: �.;�;� � ;,.��/LQ,_ic,� Telephone Number: y��3 ._E7�>c//
Mailing Address: City: Zip:
Contractor' s Name: //�� � f,,-�— C���_ai� Telephone Number: �>�'��-Qj�/
,�il • �'• ��4/
Mailing Address ;��3E,�� -t� r�l/d✓._;1-T;� ,Ts�City: :S�rr�c�r,��z���'L_ Zip: �S�S s-��; /
************************** *****************************************************
MINIMUM FEE ( $30. 00 per project)
********************************************************************************
� SYSTEM DESCRIPTION: $15. 00 each unit
Heating Systems:
Quantity:
Make.
Model.
Fuel.
Flue Size:
Input BTUs:
Output BTUs:
CFM:
********************************************************************************
{
Cooling Systems:
Quantity: ,_ `
F
Make:
Model. �
Tons:
H.Power: �
********************************************************************************
. �
*WOOD BIIRNING EQIIIPMENT , $15.00 each unit
�Wood stove with flue
Wood combination or add-on unit
Factory fire�lace with flue
Factor Fireplace (s) freestanding Masonry
Wood Stove (s ) franklin, other
BrandName ���;+L��?1�= Model No. uC�O � %
Mfgr' s Min. , " learances, side �[�, rear � , min. flue dia. � ' "
Total
****************************************��***************************************
VENTILATION $15 . 00 each project
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. Other Fans: Locations cfm
Total
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FIIEL STORAGE (must be approved by fire marshal)
' $30. 00 Permanent/Temporary
Fuel oil, gallons underg:round inside outside
LP Gas, gallons
Other Gas opening
> ********************************************************************************
: GAS LINE INSPECTION
� High/Low Pressure $15. 00
- **************************************�t********�********************************
PERMIT FEE G'.ALCQLATION
1. Total of above Installations or Mi�nimum Fee ($30.00) $
� 2 . State Surcharge. Add the State Building Code Division
Surcharge to each permit $ .50
� 3. Postaqe and Handling on all mailed.-in applications, S 1. 50
�� 4 . TOTAL PERMIT FEE add ]_ines 1-3 above $ _
. The undersigned hereby applies to th<� City of issuance of a Mechanical Permit,
agrees to do all work in strict acco:rdance with the ordinances of the City and
` the regulations of the Minnesota State Building Code, and certifies that all
't: statements made on this application a.re complete, true and correct.
� �/C,-�/
� �i� Date: 7 '
Applicant s Signature: < � � -�
� D TE TIME �
CITY OF ORONO CALLED IN ��- �� ��
INSPECTION NOTICE SCHEDULED i.z/i�/�� ���
PERMIT NO. ���'�' COMPLETED „ U �
ADDRESS '� �-S
OWNER ��O�O��, CONTR. � �
TELEPHONE NO. ����' .� 7�7 7
� DESCRIPTION �1
W 01 FOOTING ECHANICAL 16WELLTESTPUMP
� 02 FRAMING 11 ME HANICAL FINAL 18 EXCAVIGRADINGIFILLING
�
03 INSULATION 24l ' FIREPLACE 19 LAKESHORE/WETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
r09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEP�TI�C INAL
� OWNERIC NTRACTOR TO MEET YOU:�YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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� �CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. , pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL tNSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnerlContr o site:
Inspector.
White Copylinspector's File Canary CopylSite Notice