HomeMy WebLinkAbout2004-P07256 - mechanical .
� PERMIT
CITY OF ORONO Permit ►vumber:
2750 Kelley Parkway - PO Box 66 P07256
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued: 2i24i2oo4
SITE ADDRESS: 4355 Chippewa Ln
Maple Plain,MN 55359
P I D: 31-118-23-42-0020
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Mechanical Permits Permit Sub-type(s): Heating Systems
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 2,000.00
State Surcharge Fee: $ 1.00
Misc. Fee: $ 1.50
TOTAL FEE: $ 37.50
APPLICANT: Pierce Refrigeration OWNER: W�lliam&Ann McGackin
1920 2nd Avenue 4355 Chippewa Ln
Anoka,MN 55303 Maple Plain,MN 55359
THE UNDERSIGNID I�IItEBY REQLTESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
\�r Y� ��
APPL[CANT PERMITEE SIGNATU.RE SSUED BY SIGNATURE
Copies: 1-File(Sierain�res Reauired). 1-Apolicant 1-MonthlvReports, 1-Assessine, 1-Finance Page 1
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CITY OF ORQNE? RPT'LICt�'ITQI�T F�F 14�C�ANICAL PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, M1V 55323
G�RAL YN�ORI�4R'F�ON
I. You may appiy formcchanical perrruts by mail or in person at the City offices. Applications will be
reviewed and a�errnit wil]be issued within two wartdng days.
2. Ferrrut cards will be sent hy return mail after a review is completed.PERMITS ARE NOT VALID
UNTIL YOU REELNE A FERhrff!'.WflRK MUST NOT SEG1N UNTII.THE PERMIT CAR�1�S-
�OSTEI]ON THE JOB SITE.
3_ Mechanical IIes�n .-Coc�ple�e-cak��]at3ons,detai}g arr�sp+�c'rf caciotrsare r�ttired for each heating,
vrntilation,humidification-dehurrndifiea[ion,and air conditioning installation including heat loss/heat
gain calculatie�;�s�-�ers�r�cs; ec�uipmenrrat�ings and ideritificati6n as�n type,manufacturer and`
model. Data shall be preserited on form provided. Identification of and specifications for water heating
e�uipment sha�-�beprovi�eh:
4. �a17!;en az:y new cor�tructicn or remadel:ng is ir,volve:.;, a separate huil�;ng per.nit must ae obtained.
5. t�ll work must be�orrein accv�r�ar�e wirh the Ur��for�n Mechanical Code/State Building Code
requirements.
b. �tH work mttstbt_i�fetfi(t�5ug3r-in andfina]). Call(952)249-4600.28-hour notice requircd.
7. House Hezting Test ReCord must be submitted before finaL
Tnstructions
_ Complete all items on this application. Compute the permit fee. Sign and date the certification,
�OMPLB'I'�,4PP�,�E�'F�S-'�ff:�,h10`1'B�PRQCESSEI3-If`you have questions, cail
(952)249-4600.
Please check one: a New �Addition [�Re.paiz []$.eglace..Q.Residential ❑ Commerci�,
JOB STTE: �' S�S �, ��(J��' �c/CL �� Zi : S� .3S �
P �
Orr�er's Namr:_ -�1 (1'�cC���k-,,ti Pfione Number:5�,1 Z. — S�7— g B�(F�
Mailing Address: �E 3Sf G1�;(����Jc%.� �.�,►.{, Ciry: 1�1c�.�Lg, ��,�., Zip: ��-S 35�,
ContraCtor's Name: P�,2i-� �c.�-�i��Y�,� phone Number: ��3--y2l�3(�C��/
Mai1�g Address: (�2p . o�""'��"}v�- S City: �IC� Zip: �-3�`
1
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SYSTEM DESCRIPT[ON -
HEATIPiG SYSTEMS
Quanc�ry: �4
Make: �Z 1'�(1Y—
Model: �Q�,p�QC� _�`
�uel: J�P
Flue Size: � t�
�put BNs: �Ut7�oDU
Output B"IUs' J�' '.�,�
CFM: � 4 Ci
-�-r
COOLING SYSTEMS
. Quantiry:
Make:
� Model�
Tons:
H.Power
FTREPLACES GAS LINE ONLY
- ❑ Gas factory fireplace ❑ Installing a Gas Line Only
❑ Wuod burning factory€�eplace wi�t�t
❑ Wood Stove
❑ Wood stove with t�e.
Brand Ir'am�- Moc1elAIo.
VENTILA'CIC�N
2�Io. Kitchen Exhaust duct- Feealculat�g cfrrr -
Na. Bsth txhaust(must have duct vutsidej cim
No. OtheF Fans:Loca�isr�s cfm
FUEL STORAGE(MUST BE APPROVBD BY FIRE MA�tSHAI_)
❑Installation or� �F�erncve��.
❑Fuel oil: gallons ❑underground (]inside [(outside
❑LP Gas: ga�lans
❑Qther Gas opening
2
Fsb-18-2004 02;44pm From-CITY OF ORONO +8522484616 T-809 P 005/005 F-O78
PERMYT�EE CAL��3LATI�S�, �
2002 State Statute ❑ Yes Thls Section Applies
The replacemcnt of a Reaidential ft�ctnze or appliance that meets al!three of the following requirements:
1) Does not require modification to electrical or gas service.
2) �ias a total cost of$500.00 or less;excludine the cost of the fixiure or applian�e:
and
3) Is improved,installed or replaced b�thehomeowrterot lic�sed contractar.
Skip next section; Cost of Permit $ 15.OQ -�
Statc Surcharge$ .SO
Mail-In Fee $ l.5�
If above does not appl�,follov�g�ic�e}ines be}ow:
l. Contract Price''is.0125%of job with a Minimum Fee oi($35.00)
oC� O�J r� �.Q125 � J�.O'C�
feorttrnct price) (minimum 535.00) "
2.State Surcharge. '"*Add the.$ta1�8uilding.Code.Division�1klinimusp Fee o#'f�.50)
o v x .000s $ �_ C�v -
(contract price) (minimum S.50)
' 3. PostaEe and HandlinQ(Oi:ly mai!-irt applicatroc�s) $ 1.50
4. TOTAL pERMIT FEE(Add lines I-3 above) $ � �, �1
•CONTRACT PRICE or JOB COS7'means the actual or esTimated dotlar cmounc chargtd fnr tht pctmiAed+uork including
macerials,labor,proHt,and other fized cost�Jt is theamount eo�cftatgcd to-t{tecustornerpor thcwprk danr;Tf any mAterial,
equipment,labor,or instetlation is fumished by the owTier,tcnant or soy other party the reazonable m3rkd value of such items -'
must be added to the estimated cost or eonnact price for pertnic t'rc Qurpocts,In the evtnt that there is a dispuce on the amountaf
the job cost,thc Ciry may ttqucst chc submission of a signed copy of tht actunl conhacr.
••'llte S?ATE SURCHARGEis.II00S-otthacoauaet price underSF;A06,ppf}orS.59--a•hicttever is grdaitr,For valuations over
S 1,000,000 cell che Department of Inspeccional Services for ehc price. •
Tlte undersigned htrtby applies ta tha Ciry for issuanee of a Mec6enicalPettnit,agrces.to-do all�vork in strict eccordance with--
the ordinanees of thrCityand the regulacions of the Minnesota State Building Code,a�d cenifies that all statcments made o�this
spplicasion are compiece,true and corrtet.
;`X'�.: ApPkcar►c's Signaturc: Date: ��2C� �G
Approved By: Ilate:
3. _.