HomeMy WebLinkAbout1994-005888 - htg system PEI�MIT
� CIfiY OF ORONO PERMIT TYPE: ��.�;;:�-�;�:�;����;�':;;._
` 2750 Kelley Parkway • P.O. Box 815 ;;rr.';±=„=;:;:=:
Orono. Minnesota 55356-0815 Permit Number: . , -...,,. -.,_, .
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(612) 473-7357 Date Issued:
SITE ADDRESS: - -� � :-: -� -
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE . 'r� .
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CITY OF ORONO APPLICATION FOR M�CAL PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
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
sha:; :1s� b� �re�ide�.
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 final). 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 pemut 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 5 5 3 5 6 '
JOB SITE' 2435�°untry side—�r �ip•
Owner's Name: P h i 1 M i 11 e r Telephone Number: 4 7 3- 5 5 6 3
MailingAddress: 2435 Countryside Dr City: Orono Zip: ���33800
Contractor'sName: �ronstroms Heating an A/C�elephoneNumber:
MailingAddress: 7 2 01 W L ak e S t City: S t L o u i s�ip: 5 5 4 2 6
Park
SYSTEM DESCRIPTION
HEATING SYSTEMS
Qu2ntit��: 1
Make: Lennox
Model: G23Q3/4- 100
Fuel: Nat Gas
Flue Size:
Input BTUs: 10 0 , 0 0 0
Output BTUs: 8 0 , 0 0 0
CFM: 1200
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H. Power
,� �.
.
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.
Total
VENTILATION
No. Kitchen E�aust ducted recirculating cfrn
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
i. 1.2��o of Contract Price�` or ivlinimum Fee ($35.00)
-�'/. D°�c; ��; x .0125 $ �j� . ��
(contract price)
2. State Surcharge. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $ ,���
(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) $ "�l� , (`a[.�
* CONT2ACT PRICE or JOB COST mea.ls thz actuai or est:mated dallar amount charged for the per�itted
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 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 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: ,�G-�� ��,c1 Date: �//
Approved By: % ' Date: �U a�
� � ^,M '�y'_;i jt.���� �'��.i'Ga^�t '��� � ' ��J .. � �� �� � ��� �� ��'.�'M� �,, oL �_��t/;� !Xf� � ��
r ^�C R 0 N S T R 0 M S 7201 WEST LAKE ST�iEET ' � `,, ,�-� � ` ` '` Y` ` . ," �
ST. LOUIS PARK, MN 55426 �ob Name
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� HEAiING AND AIR CONUITIONWG,INC 920-3800
D'ss M��T LOSS CALCYL�TIOMS Job Addre� ,,
Weatherstrips A.S.H.V. . Construction No. I Insulation
Guide
Windows I Doors Reference Out.Wall Int.Wall Ceiling Roof Floor I Kind How Applied
Yes—No Yes—No 19_
FL� Room Length 5�-f Width Height Fl.� Room Length - Width 3 Heiqht
Windows and Dooro—Crackage and Area Windows and Doors—Crackage an3 Area
\Vldth Helght No.of Llneal[t. Area Wldth Hel`At No.ot Llneal[t. Area
No. of pane o(Dane 11ghu ot crack �Q.ft. No. ol Dane o[D��e 116ht■ o[crack �G.[e.
I � �– �L �f
<", G � 1
.� �- S � '? D _
� (o J '1-ri / � Coef. Bcu Coef. Bcu
ln6ltration 3 � 7• 7 Infiltration
Glass (i fD Glas�
Exp.wall I Eap.wall
Net exp. wall /U Z Net e:p. wall � ,� '
lnt.wall � � � �* ; Int.wall
Ceiling ('4 � ��e Ceiling
Floor � � � Floor i
Total Btu. / Total Btu. ,�,� �
Required sq. ft. E.D.R. or sq. ina. W.A. Leader area Required aq. ft. E.D.R. or aq. ins. W.A. Leader area
Fl.� Room L.ength Width Height Fl.I Room I L.ength Width Height
Windows and Door�--Crackage and Area Windows and Doors—�rac�age and Area ��
Wldth Hel�ht No.o[ Llneal ft. An• r
No. ot pane ot D��s �I�ht� o[eracic p.tt. Wldth Hef�ht No.o! Llneal ft. Area ,yJ �
�'�
No. o[pan• ot Dan• Il�ht• ot crack +Q. ft. �r�
�o� �"G
� 7 7�►
a_,.�.--�—
Coef. Btu Coef. �Btu
InFiltration Infiltration
Glasa Glass
Exp.wal) Eup.wall �
Net exp.wall Net e:p. wall ��
Int. wall Int.wal) �
Ceilin8 Ceiling ��
Floor Floor
Total Btu. 7'otal Btu. �
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required :q. ft. ED.R. or aq. ins. R/.A. l.eader area �'
FI. Room �Length Width Height Fl,� Room►L.ength W�dth ir"teight �
Windows and Doora—Crackage and Area Windows and Doors—Crac{cage and Area
Wldth Hel�ht No.ot Llneal tt. Area Wfdth He1�At No.ot Llneal tt. Area
No. ot D��• ot vane Il�ht• ot crack p.[t. No. o!D��• o[D�n• Il�ht• of crack �Q.it.
Coef. Btu Coef. Btu
Infiltration Infiltration
Glas� Glass
Exp.wall Fsp.wall
Net exp. wall Net exp.wall
lnt.wall Int.wall
Ceiling Ceiling
Floor Floor
Total Btu. Total Btu.
Required iq. ft. E.D.R. or aq. ins. W.A. Leader area Required`sq. ft. E.D.R. or sq. ins. WA. L.eader arca
HOUSE HEATING 7EST RECORD � � �
��
ADDRESS 2435 Countryside Dr APT. FLOOi�— CITY nnA�yRB
OCCUPANT hil Miller OWNE
HEAT LOSS 6 7, 12 2 DATE HTG. INST. GAS CO. METER BADGE
SOLD BY ('rnnStrnms HPat�n��nd A�C INSTALLED BY �'r�nstrnmc
Electrical Work By Gas Line By
TYPE OF HEAT GA_ FA�_ HW STEA/vl— SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE T,ennox MAKE OF BURNER
Model - Model
Serial 8 9 3J g 3 5 g Max. BTU Rating
INPUT � n n, n n n MAKE OF FURNACE
Model
CONTROLS � ��
THERMOSI� �� Heat Plug Vent Size
Valve /�� KIND OF LINER � �"��`' SIZE� NONF
Limit Draft Hood ' Regulator /
limit Setting ��" Filters Size r X x� Number �
Fan Setting Chimney Location Insi�le Outside
Pilot Type Chimney Construction -SlYc'T •ck: C taS�
Pilot Make :�.
Pilot Model Smoke Bomb Wir'irkf
Pilot Timinp Draft Test Tag
L.W. Cut Off Door Pressure Lighting Inst.
Pressure �'�1'� Percent CO2_�—Date Tested �'� ��'��
Input CFH ��-�� Percent 02 �7%—Company Testing
Stack Temp. � 9a'� Percent CO � �_Name of Tester �