HomeMy WebLinkAbout1999-012189 - natural gas PERMIT
� CITY OF ORONO : _
2750 Kelley Parkway - P.O. Box 66 PERMIT TYPE: ,: .
Crystal Bay, Minnesota 55323 Permit Number: � .,;'_��,_:��t�
(612) 249-4600 Date Issued: _ _ _., _.— .
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT;PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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CITY OF ORONO APPLICATION FOR MECHANICAL PERMTT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323 \ 'f�j
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GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be
reviewed and a perm.it 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 RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Mechanical Designs - Complete calculations, details and specifications aze required for each heating, ,
ventilation, humidification�ehumidification, and air conditioning installation including heat loss/heat gai.n
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 finai). Call 249-4600. 24-hour notice required.
7. House Heating Test Record must be submitted before final.
Instructions Complete all items on this application. Compute the pemut fee. Sign and date the certification.
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 249-4600.
Please check one: New Addition Repair Replace
✓Residential Commercial
JOB SITE: 1�_��erw oo� D U-• Zip: 553�(o
Owner's Name: hn�,.�-�,�.��{- �,�,��I;a,w�.5 Telephone Number: z� � ,a� v 9
Mailing Address: �SQ�r„� �. City: O �o v�.a ZiP: �S,3S�
Contractor's Name: C.oc.,,�.-E-r c.,s c'�� �-���,nw�GC�,.Telephone Number: �(--t�_�� c,�
Mailing Address: 6 S c l l�w�, l� . �-�t3'= �M.�..n c.e PC a;�. Zip: S S �'9 �
SYSTEM DESCRIPTION
HEATING SYSTEMS
Quantity: i
Make: ��vy�wv�t-
Model: �3U �v n y w8o
Fuel: �v� .
Flue Size: � '`
Input BTUs: �a�vao
Output BTUs: �t-1,��o
CFM: i(�bp �
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H. Power
. e
�
. �
WOOD BURNING EOUIPMENT
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 '�
FLTEi STO�ACTE (i�1US i �sic Ai t�R�'i`JED BY FI^� 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) ._
�a�-a o-' x .o12s $ �S
�(contract price)
2,. State Surcharge. ** Add the State Building Code Division � u
Surcharge to each permit. x .0005 $ I `�
or $.50, whichever is greater (contract price)
3. Posta�e and Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ �,�7 �°
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount chazged 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 pany tne reasonabie market vaiue of such ite� riiusi be added ta the estirnated cost
or contract price for pemut 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 cio
all work in strict accordance with the ordinances of the City and the regulations of the Minnesota
State Building Code, and certifies that all statements made on this application are complete, true
and correct.
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Applicant's Signature: � Date: l l- 1 b r �
Approved By: Date: l I '�2 � 5