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Home My WebLink About2014-00992 - gas line only . ., CITY OF ORONO * 2 0 1 4 — 0 0 9 9 2 * 2750 KELLEY PARKWAY DA'rE [SSUE�: 09/03/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2630 COUNTRYSIDE DR W PIN : 04-117-23-12-0015 LEGAL DF,SC : OLD CRYSTAL BAY ROAD ADDN : LOT 007 BLOCK 002 PERMIT TYPE : MF_CHANICAL(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY NOTE: GASLINE TO 1'IREPLACI;- I ST FLOOR APPLICANT MECHANICAL(<$500) I5.00 STATE SURCHARGE MECH(<$500) 5.00 PROMECI-1 LLC TOTAL 20.00 121 ]0 IDAHO AVE N CHAMPLIN, MN 55316- Payment(s) (612)518-3066 CHECK 7956 20.00 OWNER URNESS, TODD& KATHERINE 2630 COUNTRYSIDE DR W LONG LAKE, MN 55356 ACREEMF,NT AND SWORN STATEMENT I�he work for which this permit is issued shall be performed aecording to the approved plans and specifica[ions,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or nol specified herein.'I�his permit will expire and becoiroe null and void if construction authorized is not commenced within 180 days of[he date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. Ihe applicant is responsiblc for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at anv time for due cause. -`" � �� 9' i �- i �f App ' a ermitce Signature Date Issue y Signature Date � ,� FOR CITY USE ONLY �O�O City of Orono P.O.Box 66 Date Received: Permit# 2750 Kelley Parkway Crystal Bay,MN 55323 Approved By: Amount$: Phone(952)249-4600 Fax(952)249-4616 � � y � F � �q �� CITY OF ORONO —MECHANICAL PERMIT KES H�� (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshail) GENERAL INFORMATION l. 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. Permit 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 Desiens—Complete calculations,detaiis 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 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(952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before final. TYPE OF PERMIT (Check All That Ap ly) �esidential ❑ Commercial (Approval Required) ❑ New �dditional ❑ Repairs ❑ Replace Job Site / Owner Information: Site Address: �S'C'� ��N.JleL.c�.+v� � Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: �'o/�� Contact Person: Address: /�/!0 �.ie�l.�,�_r� ) State Bond #: //��8� City: Zip:�� Expiration Date: 7��, Phone: �� —S�� "-3C�(�o Alternate Phone: 7�,�'S76 ' �0� ❑ Insurance—Current: 1 � f 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: Model: Fuel: Flue Size: Input BTUs: Output BTUs: CFM: 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/Masonry VENTILATION ❑ No. Kitchen Exhaust duct recirculating cfin ❑ No. Bath E�chaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (Must be approved by Fire Mars/zall if proposing to abandon tank in place.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoar Grill � Other/List What&Where:�� y�.� 2 ` . � PERMIT FEE CALCULATION(S) BASED OFF - 2002 STATE STATUE ❑ Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: l. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less; excludin�the cost of the fixture ar 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 $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ PERMIT FEE CALCULATION(S)—JOBS OVER $500.00 If above does not appl�; follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) �� ,o�i. x .0125 $ (contract price) (minimum$50.00) 2. STATE SURCHARGE r:J 3sa" X .000s $ (contract price) 3. POSTAGE&HANDLING (Only on Mail-In Applications) $ 2.00 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 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. MECHANICAL PERMIT APPLTGATION 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. Applicant's Signature: Date: l��/�''� 3 ,: � ��`-` � TE � TIME � CI OF ORONO CALLED IN , INSPECTION J�IQ � SCHEDULED � -� PERMIT NO. r — COMPLETED �_ ADDRESS � S� �� OWNER TELEPHO E N �� a CONTRACTOR �; DESCRIPTION � � /� �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL � HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEP I FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOFi T�U: YES_NO � COMMENTS: � W a � J O �. � O � W � _. Q � 2 W � W � J GW ❑WORK SATISFACTORY:PROCEED ROJECT COMPIEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED D STOP OROER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advan �9 -4600 OwnerlContractor on site: Inspector. � ' White Copyllnspector's File / Canary CopylSite Notice