HomeMy WebLinkAbout1996-007979 - hat gas heating system ; ,� PE�RMIT
4 CITY OF ORONO PERMIT TYPE:
??50 Kelley Parkway- P.O. Box 66 ����;�;��;;�?�.�L
Permit Number:
Crystal Bay, Minnesota 55323 �:��}�i'=�,'`�
(612) 473-7357 Date Issued: ;�`�..�,� ;��;
SITE ADDRESS:
1 ;�ii i ��i�A�:��::ETT°�� �`�?I�=�� �°4�t
:�'E,
F' . �: . t�f. . f #.—�. 1.?—�°�`—�=`�—�:���a;.7
DESCRIPTION:
f. �-!F�'.E�T T�vti -�Y:_:!���f:-� I�i !1% :���::�. �.�" �tl�'�.. �Mt::t I��_1FiF;�. E�F�'_;
�i����::� t'�Y Dh��_�TI'��:�t 1 t•ir��i��.� t•i#•ra.:;�i:;C:
1_1�_J3 �`!}f ;':j,`�f� •_t){_) jf:���lft :�.'z'tijf7iifi
REMARKS:
FEE SUMMARY:
sJ����t�T I►�jP�! ��,, =�°�t;
C'C:{=F? F_F:N 2�,+Jt�. � � l�I"�1L ��M ..__.._...._.�_. ..,...i.�.a.���
=��1t1`[! S•il�'•��, ___.__..�_ ��."+ '�'? � i�i t..-_i� �}NC ~'.t..i_i�. . .`zi`
s__.�:a.
_;����t.��t.�.l �:�,�:�; .;;,_;
CONTRACTOR: — q�=�,i i���;t. — OWNER:
t:��E�TF`.r'�I F�:�. i�t�s: =�'�r�1 1 i i,r�.•-� t=j,i i_'=�%;;_i;=ii' �'L-����is��
i��i a;� t�G,��;#-�T��i;3���h,( �:��,:� � ;.:�;t�yi 7 E��i'3���':�T��=; F��:�I t�T �;€�3
�C��t�� F`hr'�T�°!�: t��•� �,�:;�i.� C�1'i�_���I#�s t•1i�1 h�:�,��t�.
t:F,f•,;=i ��i�.1 -�j.i�1{.�. �.7:=;-'=t t�.:�::?.
1't-!E= !11��?��'_;f{.;t,E��'� Fi��:r��Y :�.fy::�'_'�°:�T':; i='�=�°t•i i':�=�i�:±i�� T�=� i•1���::r� ii�� [�:�=r�!-- i±°i�='i;�=��•:L.i��E:t��1'°=:
,-.. • _ , ._. _ _.._.
._.F°r�;I�I E i:7 r�P,�(� ��c�;��_�,'_; i;_:� �:3f�� �°ti_�_,. �:��_��E::, ����# �=;���f i:�� �_.�.�t��°i���;v:::?�: �.�.:T-i��; �'�.'_..�... i:1_�T�' i_��-
L e=�f;f,i���i,E i�Ri1 I i+�Ai�l+:��°�� r�t�iis =�i r�����. :�=i= ;•i E i��t��:�;!i T� [—;t 1 I LD i t�i� t_a_t��� i;�,;�F���=�°E:t�i�i a'r°� . �
�
���'l,/.�����-d� .�""" ' - U�� 't��
APPLICANUPERMITEE SIGNATURE ISSUED BY:SIGNATURE
._ .... �"".,�
: �� i i;�-�'��l��'� �R,�,
CITY OF ORONO APPLICATION FOR MECHANICAL PERMTT
Box 66 (2750 Kelley Parkway) �
Crystal Bay, MN 55323 OCT '` � .
GE�IERAL INFORI�IATION
1. You may apply for mechanical pernuts by mail or in person at the City offices. Applications will be
reviewed and a permit 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 RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Mechanical Desi�ns - Complete calculations, details and specifications are required 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. Identification of and specifications for water heating equipment
shall also be provided.
4. When any new construction or remodeling is involved, a separate building pennit �ust be obtaiaed.
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 fina]). Call 473-7357. 24-hour notice required.
7. House Heating Test Record must be submitted before final.
Instructions 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.
Please check one: New Addition Repair �_Replace
� Residential Commercial
JOB SI'TE: 1 3��r' �������� i�T �'��� Zip:��,-,-
Owner'sName:!--��n��/���Lllv P�ll�l�;�r"�✓ TelephoneNumber: �i;�� – �' � �
Mailing Address:r��r3r r1c;�=� f i-� ,�.(.���� City: ��f�^�.r?�� Zip:_���9%
Contractor'sName• ��»–rai,� �,. Tele honeNumber: -���–I���
MailingAddress:�1,9'>�� �,t���1'a�r�����r> �-�–� City:� ����� �Zip:�'-'�•%�
SYSTEM DESCRIPTION
HEATING SYSTEMS
Quantity: �
Make: i �'+
Model: J����
Fuel: r3nr ' �..�r
Flue Size: d�"
Input BTUs: r�� . i
Output BTUs: �,� .y�_
CFM: ���` �
,,���
COOLING SYSTEMS � �\
Quantity: � ,
Make:
Model:
Tons: —
H. Power
�:������ ���i � 3 q�9�
-� �
WOOD BURNING EQUIPMENT
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.
Total
VENTILATION
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. Other Fans: Locations cfm
Total
FUEL STORAGE (MUST BE APPROVED BY FIRE 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
/,- %; ��!'i x .0125 $ �'�, ��
(contract price)
2. State Surchar�e. ** Add the State Buildin Code Division
Surchai•ge to each permit. ���,' :� x .0005 $ � : l�
(contract price)
or $.50, whichever is greater
3. Posta�e and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 53`��. =��%
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged 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 fumished 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 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 do
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. �
� " � �'
Applicant's Signature: �'� � �� �"��:`�� Date: � �3�— ���'�
Approved By: L� Date:
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED 2- �3'�1 C� I�:c�o
PERMIT NO. cOMPLETED
ADDRESS 13� Q��C�--�s Poc�vT (Z�
OWNER �- P(�(�5 ��CONTR.
TELE�HONE N .
� DESCRIPTION ��SGu�S GX�S�'►N5 /y/4svT�Z Gl�C.��Q�pS
� 01 FOOTING 11 MECHANICALRI 18IXCAV/GRADINa/FIWNG
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WqLL BD. 12 WATER HOOK-UP �ITE INSPECTION
Q
= OS FINAL 14 SEWER HOOK-UO p6 PROGRESS
F' 07 DEM��ITE 27 SEPTIC MAINT. 21 COMPLAINT
�
Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINQ F�NAL 36 FOUNDATION REMOVAL
Z OWNER/CONTHACTOR TO MEET YOU:_YES_NO
� COMME S:
� � . ' r'
j S �' �
� �er a ' � s s �i'�
�
Q 4
� �
Q3 ` �` � �
� }� �
Z
W
�
W
�
�
d C WORKSATISFACTORY:PROCEED - PROJECTCOMPLETE
W
� C CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
W
O �: CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. r- pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR -- CITATION ISSUED
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspecti 24 hours in advance.473-7357
Owner/Contractor
Inspector. �
White Copyllnspector's File Canary Copy/Site Notice
���a---
HOUSE NEATING TEST RECOi2G
ADORESS _���-'l1 t/rQ�'�e�S ( �. �• APT. FLOOR �__CITY S1. �n�SUBURfi_.
Oi.CUPAN1 --�� ITS bur — ---owwert -- -- - - –
NFAT LOSS __—_ AT H�G. INST. __ _ • __�___ _
SOI.D BY _ G.�{ _:��+ _____INSTALLED BY _���1 G�/'�_��_, __
�I�chicaf Work &f —�� S Gos Lin� By —�� _-��
TYPE OF HEi,T GA FA _HW __ STEAM SPACE HTR. UNIT MTR. OTMER _ _ —
GAS i�ESIGN CONVERSION
MAKE _._ �� O _ AAAKE OF BURNER �______
Mod.l _ � '� Cj" Abd.l
��al _--�(��.1SFl7� _ Mex. BTU Ratley – —
INPUT �otD�� MAKE OF FURNACE
Mod.l
CONTROLS � '� �-/��
THERMOSTAT _ �� ���y V�nt Si:• ��
va��• � — KIND OF LINER_ SIZE NONE („�._
I.ir.+ie _____���_ Droh Hood _ rR�yulawr i ��
Liinit SsMin9 — � ^. Fi ItNs Siz���T� 1�7 M� � �
Fan S�ttiny a� (]iimn�r Loeation Insid� Outsid•
Rilot Typ� t]�imn�y Const►ucilon __
Pilot Mak. er�v'��`� �
Pilw A4od�) ~ Sw�ok• Bomb � • ;ny
Pilor Timin9 — ^ D►aft T.st Top �-'�'�
L.W. Cut Of( Dow pr�ssut� Llyhtinp Inat. �
Pr�ssur• �� W vP����nt Cp —__IL_ Dot� T�st�d
Input CFH— �� __P�rc�nt O� � Conqwnr T�sting Q ��
2
Swcic T•mp. — Perc�nt CO ��Nan»of T�st�► --� v '
HOUSE HEATING TEST RECORD
ADDRESS ��� �������' `� ` ��•_'�—APT. FLOOR CITY S:.L�'SUBURB
OCNPANT �� � � 'Y OWNER
HEAT LOSS DAT�HT,G. INST. _ "'
SO�D BT ��,�1' �.�-li-r� ' r�� IlISTALLED BY -�1 ���►f' i�' � �
EI•crricol Wwk By �'�T�-� Gos Lin� Br 1.�. ��
TYPE OF HEAT GA FA �HW STEAM _--_SPACE HTR. UNIT HTR. OTMER
'r _f G 5 DESIGN CONVERSION
MAKE _ �(=��'E�� MAKE OF BURNER
A4od�l /�') '`fr��,� _._ IAod�l _
�
s«�a� 1'►7K� t�✓x-- __ ►�Aox. 97u ttar��9
INPUT L�,,;��XX� �s �) __ MAKE OF FURNACE
Mod�l _ � ` �,
CONTROLS
THERMOSTA H.aI�P V•nt Si:•
Valv _-�--��!� ' V'� � ���- ��IND OF LINER a � SIZE�N
Limit t''N` ' Drah Nood __ � R�yula�or �,�-�
Limit S�niny �f�� ��- -- Filt�rs Si:• ►rumb�r
Fan $�rtiny Q�imn�y Location Insi �Outsid•
Pilot Typ� _ �3 �i/1. C}+imm�y Construdion ����
Pilot AAok• __. f��tZ.1�1.�i�
T
Pilot Mod•I __ _ Smok� Bomb _ Wirinq �
Pilot Timiny _ D�aft T�st Top—�+'
L.W. Cut Off —� � Dow Pr�ssw� Liyhtiny In�t. �
S�'`,� � s
Pnssuro �_3��"^'i�P�rcenf CO� -� Da» T.s�.d _ r� � ���� '�'
Inpu� CFH_���1 P�re�nt OZ ' _ Co,�o�r Te.���. '`r-�iC; �i'F-� �+y�/,;,�' -
Srock Temp. P�rc�nl CO ° � NanN oF T�st�► �+�%� -