HomeMy WebLinkAbout2008-00325 - mechanical CITY OF ORONO PERMIT NO.: 200&00325
� 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 10/23/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 2715 COUNTRYSIDE DR W
PIN : 04-117-23-12-0019
LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN
: LOT 004 BLOCK 003
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RES[DENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 700.00
NO"I'E:
1 KITCHGN EXHAUST
1 GAS LINE
APPLICANT MECHANICAL 35.00
KLEVE HEATING&AIR STATE SURCHARGE MECH (VALUATION) 0.50
6365 CARLSON DRIVE SUITE G
EDEN PRAIR[E, MN 55346- MAIL-[N FEE 1.50
(612)941-421 1 TOTAL 37.00
OWNER
WILSON, MARK& KIRSTIN
2715 COUNTRYS[DE DR W
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMEIVT
The work for which this permit is issued shall be performed according to
the approved plans and specitications,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 not specitied herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days oY the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
I'he 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�,ause.
�'jl�t.e�.c.� C.tL l l
� �
Applicant Permitee Signature Date Issued By nature Date
SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESC ED ABOVE.
� FOR CTTY USE ONLY
�� City of Orono
'�"�\ Date Received: Permit#
• O O` P.O.BoY 66
�?,.� 2750 Kelley Parkway
,1��2Jl.y,� Crystal Bay,MN 55323 Approved By: Amount$:
���}���.�� (952)249-4600
CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Building O�ciat or Inspector and/or Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical permits by mai] 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. Ivtechanical Desi�ns—Complete calculations,details and specifications are required for each
heatin�,ventilation,humidification-dehumidification, and air conditioning installation including
heat loss/heat�ain calculation,design temperatures, equipment ratines and identification as to
rype, manufacturer and model. Data shall be presented on form provided.
4. When any ne�v construction or remodeling is involved, a separate building permit must be
obtained.
5. All �vork must be done in accordance with the Uniform I�techanical Code,�State BuiidinQ Code
requirements.
6. All work must be inspected (rou�h-in and final). Call (95?)2�19-4600.
(24--13 hour notice required)
7. House Heatin�Test Record must be submitted before final.
TYPE OF PERIvIIT
� (Check All That Applv) I
�esidential ❑ Commercial (.�,oproval Required)
❑ New �Additional ❑ Repairs ❑ Replace
Job Site / Owner Information:
Site Address: ��S � ,
O�vner:�r•° M1�S. �� tilailing Address:
Citv: � Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor:KlPVP ufi.n _ �.A/C' Inc Contact Person: Ashley Griffin
Address: 636� � 1 �on Dr Ste GState Bond n: RT,r—SF, i 1 6�
Citv: Eden Frairie Zip: 553�6Ezpiration Date: 8/14/b9
Phone: 952-941-4211 Alternate Phone: Q52-345—i 242
❑ [n�urance — Current:
1
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HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFVt:
COOLING SYSTEIIS
Quantity:
1�lal:e:
\-(cde!:
Tons: �
H. Power
FIREPLaCES
❑ Gas Factory Fireplace
❑ Wood Bumin� Fireplace
❑ �Vood Stove
❑ Wood Stove With F(ue
Brand�1ame: tilode! \o.:
VEtiTILATION
� No. � Etitchen Erhaust duct recircula[ine �D cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Loca[ions c`R�
FUEL STOR,�.GE (�IliST BE APPROVED BY FIRE �I.�RSHALL)
❑ Installation ❑ Removal
Fuel OiL �allons ❑ linderground ❑ Inside ❑ Outside
LP Gas: �allons
Other:
G.-�S LI!VE OiYLY'
❑ Outdour Grill � Odicr/ List ��h,u �e �4'her�: ��,_� �L��� `1�.�)r�' '�.J�.
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; �- ;`,i 5 ;�, ''`;`�ti s°' `�L; ,�PEI2MIT FEE CAi;CUI��1TIbN(S)�� ' ;�� , ,� ` , ` :
f I .�y � i.�h� ♦ �...: � L� �;:17i ta� f".;. r�r. a._• 1 �e (' U � ` � ' "��,
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;'.;';' `� ��.,s;s��'x.;',.�_ y .��BASED"OEE,:�2002:STATE STATUE ,�. . �'� ��� �
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❑ Yes,this section applies
The replacement of a Residential fi�cture or appliance that meets all three of the followin�requirements:
1. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or(ess; excludin�the cost of the fixture or appliance: and
3. [s improved, installed or replaced by the homeo�vner or licensed contractor.
Skip next section, if this applies; Cost of Permit � 1�.00
State Surcharge $ .50
Mail-In Fee(If Applicable) � 1.�0
Total Permit Fee S
"-` PERMIT FEE CALCUI,ATION S) =JOBS OVER $�00.00
If above does not apply; follo�v�uidelines below:
l. CONTR.�CT PRICE * is 1.��°a of contract price with a (�llinimum Fee of 53�.00)
� �� 00 �g�
, � .Ol'� S �
(convac:pnccj �� �minimum���00)
2. ST�TE SL!RCH.aRGE *' .�dd the State Bld�_ Code Div. Surchar_e (�linimum Fcc ofS.�O)
� W .� x .000� S . �.J v
(contrct pcice) (minimum� �O1
�. POSTAGE �. HANDL[NG (Onl�• on 11ai1-In Applications) S 1.�0
�
-t. TOTAL PER��IIT FEE (Add Lines 1-3 Above) S •
• ` CONTR.�CT PRICE or JOB COST means the actual or estimated dollar amount char�ed for the
permitted wark including materiafs, labor, profit, and other fixed costs. It is the amount to be char_ed
to the customer for the �.vork done. If any material, equipment, labor or installations are fumished by
the owner, tenant or am� 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 si�ned copy of tlie actual contract.
• ** The STATE SURCHARGE is .0005 of the Buildin� Department at(9��) 2=t9--t600 for the price.
�• : ' iv1ECHAI�IICAL PERMIT APPLICATION AGREEMENT
The undersigned hereby applies to the City for issuance of a Niechanical Permit, a,rees to do all
�vork in strict acc ance'��with the ordinances of the Ciry and the re�ulations of the State of
Iviinnesota, and certifies th�at all statement��de on this application are �ompl�te, true and
correct. ��,
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Applicant's Si�,na�u.�e_ � ate;� � �
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,� Reset Form • ,
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