HomeMy WebLinkAbout2009-00291 - cooling system CITY OF ORONO PERMIT NO.: 2009-00291
2750 KELLEY PARKWAY
� ORONO, MN 55356- DATE IssuEv: 06/08/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 1580 BOHNS POINT RD
PIN : 09-117-23-33-0008
LEGAL DESC : UNPLATTED 09 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : COOLING SYSTEMS
VALUATION : $ 6,400.00
NOTE: 2 LENNOX 4 TON AC
APPLICANT MECHANICAL 80.00
KLEVE HEATING&AIR STATE SURCHARGE MECH(VALUATION) 3.20
6365 CARLSON DRNE SUITE G
EDEN PRAIRIE, MN 55346- MAIL-IN FEE 2.00
(612)941-4211 MISC FEE 0.00
TOTAL 85.20
OWNER
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1580 BOHNS PT RD
WAYZATA,MN 55391-
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 separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become nuil and void if construction authorized is no[
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.
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Applicant Permitee Signature Date Issue y i nature te
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
FflR CITY U3E ONLY
O,�p�,O City of Orono —
P.O.Boa 66 Date Reaeived: Permit#
`�,-. 2750 Kelley Parkway
� � ;�C. Crystal Bay,MN 55323 Apprrned By: Amount S:
�� (952)249-4600
CITY OF ORONO-MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspcctor endlor Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City of'fices. Applications will
be reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT
VALID LINTIL YOU RECEIVE P,PERMTT WORK MUST NOT BEGLTI LTI�TIL THE
PERNIIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desistns–Complete calculations,details and specifications are requued for each
heating,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.
4. When any new construction or remodeling is invoived,a separate building pernut 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(rouph-in and final). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERNIIT
Check All That A I
�Residential ❑Commercial(Approval Requued)
❑New �Additional �Repaus �Replace
Job Site/Owner Information:
Site Address: �� �1� �• �� -
Owner:`�"�1\��m l�-'��� Mailing Address: ��
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: Kleve Heating &AC Contact Person: �hley Griffin
Address: �3075 Pioneer Trail State Bond#: RLI-561165
C��: Eden Prairie Zip: 55347 Expiration Date: 08/14/09
Yhone: (952}941-421� Alternate Phone: (�52) 345-7242
✓❑ Insurance-Current:
1
k�,-
Note: All Geothermal Systems will now require a Site Plan& Review by our Building Official.
IS THIS GEOTHERMAL? ❑ Yes ❑No
HEATING SYSTEMS
Quantity:
Mal:e:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING 5YSTEMS
Quantity: �
Make: �n'�
Model: �✓v "` �
Tons: � �'n
H. Power
FIREPLACES
❑ Gas Factory Fueplace Brand Name:
❑ Wood Burning Fueplace
� Wood Stove Model No.:
❑ Wood Stove With Flue
VENTILATION
❑ No. Kitchen E�aust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by�re Marshall ijproposing to abandon tank in place.)
❑ Installation a Removal
Fuel Oil: gallons ❑ Underground a Inside �Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Chitdoor Grill ❑ (�ther/List What&Where:
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PERMIT FEE CALCULATION(S)
BASED OFF- 2a02 5TATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets al]three of the following requirements:
1. Does not require modification to electncal or gas service.
2. Has a total cost of$500.00 or less;excludinu the cost of the fiature or appliance:and
3. Is unproved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Permit $ I5.00
State Surcharge $ 50
Mail-In Fee(If Applicable) $ 2.00
Tota1 Permit Fee $
If above does not apply;follow guidelines below:
1. CONTRACT PRICE • is 1.25%of contract price with a(Minimum Fee of$50.00)
l � C��j �i GC'�
"l�/ x A 125 $ � .
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Atinimum Fee of 5.50)
�`f\J�-�' • CX-
x .0005 $
(convact price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE�Add Lines l-3 Above) $��Q,�
■ ' CONTRACT PRICE or JOB COST means the actual or estunated dollar amount charged for the
pemutted 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 installations 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 STATE SURCHARGE is .0005 of the Building Department at(952)249-4600 for the pnce.
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and ce �es at all statements mad on this application are complete, true and
correct.
Applicant's Signa�e: ! Date:
Reset Form '� __
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