HomeMy WebLinkAbout2009-00310 - heating systems � CITY OF ORONO PERMIT NO.: 2009-00310
2750 KELLEY PARKWAY
� ORONO, MN 55356- DATE ISSUED: 06/1U2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 2735 COLTNTRYSIDE DR W
PIN : 04-117-23-12-0018
LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN
: LOT 003 BLOCK 003
PERM[T TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 4,264.00
NOTE: 1 BRYANT NATURAL GAS FURNACE
APPLICANT
MECHAN[CAL 53.30
STANDARD HEATING &AIR CONDITIONING STATE SURCHARGE MECH (VALUATION) 2.13
410 WEST LAKE STREET
MINNEAPOLIS, MN 55408-2998 MA[L-IN FEE 2.00
612-8242656 TOTAL 57.43
OWNER
ALEXANDER, TIM
2735 COUNTRYSIDE DR W
LONG LAKE, MN 55356
AGREEMENT AND SWORN STATEMENT
The work Yor which this permit is issued shall be performed according[o
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 specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within l80 days of the date of issuance,or if consVuction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring alI required inspections are
requested in conformance with the State Building Code.This permi[may be
revoked at any time for due cause.
�
���'GQ'c'� �. l l l l
Applicant Permitee Signature Date Issued By S' ature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE.
FOR CI'I`Y USE OhLY'
� ��`�� City of rono
f � � �zt P.O.Box 6 � � Date Receive8: � � Pennit#
� r� �,, - —
,, ,i 2750 Kelle� rkway
�j t��'��� � �� Crystal Bay,M Approved Dy: � Amount$:
� ':�d�l �,:,�,�o��` (952)249-�3600
� .Mc�xo4
C[TY OF ORONO—MECHANICAL PERMIT
(All Commerciul pemiits mu�t be:�ppm��ed hY thc 13uilding O�licial or Inspeclor and'or Fire�1arshall)
GENERAL INFORMATION �
l. You may apply far mechanical permits by mail or in person at the City offices. Applications will
be reviewed and a pern�it will be issued within t�a�o working days.
2. Permit cards�vill be sent by rcturn mail after a revie���is completed. PERMITS ARE NOT
VAL1D UN"C1L YOU RLCLIVE A PGRMIT. �1'ORK�7US7'NOT BEGIN UNTIL TIIE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical DesiQns—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air condirioning 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 Mechanica]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 A� 1
�Residential �Commercial (Appro��al Required)
� Ne��� ❑Additional ❑ Repairs �2eplace
�/ �
Job Site/Owner Information:
Site Address: � l c� � S l� �
Owner: L(� � ��%V�(1GI'ailing Address: S�iYYti/ .
City: 0 J� �_ Zip: ��3�G,
Home Phone: �Z��(3' �l ��te Phone:
Contractor Information: �
Conh�actor: Contact Person: �
STANDARD HEATING& AIR CONDITIONING
Address: 410 WEST LAKE STREET State Bond #:
MINN , MN 55408-2909
612-824-2656
City: Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance—Current:
1
� MECHANICAL SYSTEMS BEING 1NSTA��FD £ • .�,� � �
� Note: All Geothennal Systems will now require a Site Plan& Review by our Building Official.
IS THIS GEOTHERMAL? ❑ Yes �No
HEATING SYSTEI�IS
Quantity: �
Make:
Model: S
Fuel: ��,��
Flue Size:
Input BTUs: /�Q����./
outpuc BTus: /I 4�
CFM:
COOLING SYSTEMS
Quantity: ___ _ _
Make:
Model:
Tons:
H. Po���er
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Pireplace
� Wood Stove Model No.:
❑ Wood Stove With Flue
V ENTILATION
❑ No. Kitchen�xhaust duct recirculating cfm
❑ No. E3ath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORACE (Must be approved by Fire Marslial/iJproposing Io abandon taiak in place.)
� Ii�stallation � Removal
Fuel Oil: gallons ❑ Ui�derground � 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
� Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1. Does not require modification to elechical or gas service.
2. Has a total cost of$500.00 or less;excludin�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) $ 2.00
7'otal Permit Fee $
PERMIT FEE CALCULATION(S)—JOBS OVER$500.00
If above does not apply;follow guidelines below:
l. CONTRACT PRICE * is 1.25%of con act price ith a(Minimum Fee of$50.00)
�� X .o�2s � �,, 3 C7
(contract price) (mii�imum$50.p0)
2. STATE SURCHARCE **Add the State Bldg Code Div. Surcharge(ntinimum Fee of�.50)
__���z .0005 $ � '/�
(contract pnce (minimum$ .50)
3. POSTAGG&HANDLING(Only on Mail-In Applications) $ 2.00
L
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 installarions are furnished by
the owner, tenant ar any other parry, 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 C3uilding Department at(952)249-4600 for the pricc.
°'MEC'HANICAL PERMIT APPLICATION AGREENIENT
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
�vork in strict accordance wiCh the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all stateinents on this application are complete, true and
correct.
Ap��licant's Si��n tu� . ate: � �/
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