HomeMy WebLinkAbout2009-00038 - mechanical CITY OF ORONO PERMIT NO.: 2009-00038
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE �SSUEv: 02/03/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 2420 COUNTRYS[DE DR
PIN : 04-ll 7-23-11-0003
LEGAL DESC : COUNTRYSIDE MANOR
: LOT 001 BLOCK 001
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 3,000.00
No�rE:
1 TRANE GAS FURNACE
APPLICANT MECHANICAL 37.50
UNITED HEATING&AC STATE SURCHARGE MECH(VALUATION) 1.50
TOTAL 39.00
OWNER
NATHANSON, ROSS
2420 COUNTRYSIDE DR
LONG LAKE, MN 55356
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 docs
not grant permission for additional or related work which requires separatc
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit wili
expire and become null and void if construction authorized is not
commenced within l80 days of the date of issuance,or if cons[ruction 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 c nformance with the State Building Code.This permit may be
rcvoked at an�time for due c
i! � � �/i"�-� l l
pplicant er itee ignature Date Issued By S gnature ate
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBE ABOVE.
I �Y
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FOR C1TY I;SE ONLY
,��� City of Orono
O� O P.O.Box 66 Date Received: Permit#
�,;{� 2750 Kelley Parkway
a � �9l�,z��.� � Crystal Bay,MN 55323 Approved By: Amount$:
�� ���i!�`o'` (952)249-4600
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CITY OF ORONO —MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or lnspector and/or Fire Marshall)
GENERAL 1NFORMATION
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will �
be reviewed and a permit will be issued within two working days.
2. Pernut cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desi�—Complete calculations, details and specifications are required for each
heating, ventilation, humidification-dehumidification, and air conditioning installation including
heat loss/heat gain calculation, design temperatures, equipment ratings and identification as to
type,manufacturer and model. Data shall be presented on form provided.
4. When any new construction or remodeling is involved, a separate building pernut must be
obtained.
5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code
requirements.
6. All work must be inspected(rough-in and final). Call(952)249-4600.
(24-48 hour notice required)
7. House Hearing Test Record must be submitted before final.
TYPE OF PERMIT
(Check All That Apply)
�esidential ❑ Commercial(Approval Required)
❑ New ❑Additional ❑Repairs �place
Job Site/ Owner Information:
Site Address: <� y� � C �`�'� '�`� S � "< < ����
Owner: /` r'S`s /j/" f-L``�`.�s�°�I Mailing Address: "2`f`�U G `�`„� °�� `S� `� 'v��
City: �_��`l� �G��C /'��`" Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor. ��'�� lT``�`�� '�Contact Person:
Address: �`Z ys �7�`����'r'`�C f�`��'State Bond #:
.SJ`3 Y�
City: a����'�"Z Zip:�� Expiration Date:
Phone: 7� 3 -$ y� - ��`� � Alternate Phone:
❑ Insurance—Current:
1
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MECHANICAL SYSTEMS BEING INSTALLED = :
Note: All Geothermal Systems will now require a Site Plan& Review by our Building Official.
IS THIS GEOTHERMAL? ❑ Yes�No
HEATING SYSTEMS
Quantity: �
Make: ���'`__ d v ��
Model: `�.0 /�(' q(� �
Fuel:
� ; �
Flue Size: U L �
Input BTUs: ��� �� `
output BTus: �� , o��
CFM: ��C�O
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H. Power
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove With Flue
VENTILATION
❑ No. Kitchen E�aust duct recirculating cfin
❑ No. Bath E�aust(must have duct outside) cfm
❑ No. Other Fans: Locations ��
FUEL STORAGE (Must be approved by Fire Marsha[1 if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
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PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
`��<<'�' s',�this section applies
�
Th replacement of a Residential fixture or appliance that meets all three of the following requirements:
1. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less; excluding the cost of the fixture or appliance: and
3. Is improved, installed or replaced by the homeowner or licensed contractor.
Skip next section, if this applies; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) � 1.50
Total Permit Fee $
��� - PERMIT FEE CALCULATIQN(S)—JOBS OVER$500.00 ` `
If above does not apply; follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$35.00)
��bDO. D(� X .oi2s $
(conttact price) (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of�.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
• * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted wark 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 installarions 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 price.
MECHANICAL PERMIT APPLICATION AGREEMENT �
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 certifies that all statements made on this application are complete, true and
correct.
�' '—_
'� 2 —� -- � 7 .
Applicant's Signature: Date:
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