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Home My WebLink About2010-00587 - gas line only CITY OF ORONO PERMIT NO.: 2010-00587 ` 2750 KELLEY PARKWAY � ORONO, MN 55356- �ATE [SS[1ED: 07/15/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 2775 COUNTRYSIDE DR W PIN : 04-117-23-12-0016 LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN : LOT 001 BLOCK 003 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY VALUATION : $ 1,700.00 NOTE: GAS LINE ONLY TO POOL HEATER&SPA HEATER APPLICANT MECHANICAL 50.00 METRO GAS INSTALLERS STATE SURCHARGE MECH(VALUATION) 5.00 685 141ST LANE NW TOTAL 55.00 ANDOVER, MN 55304 (763)754-7119 OWNER MURLEY,TODD&MARY 2755 COUNTRYSIDE DR W 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,applicabie 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 permi[s. All provisions of laws and ordinances goveming[his type of work shall be compied with whether or not specified herein.This permit will expi�e and bccome null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of l80 days at any time afier work has commenced. Thc applicant is responsibl for assuring all required inspections are reques[ed in confo man ith the State B ' ' g Code.This permit may be revoked at e due e. l l / G�� `7 - �,S� � Applicant Permitee Signature Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ¢ � FOR C1TY OSE ONLY , ,�� City of Orono O O P•O.Box 66 Date Received: Permit�} I � �,�, 2750 Kelley Parkway �[) ` � ��r,��'-- Crystal Bay,MN 55323 Approved By: Amount$: J-. I � ��o� Phone(952)249-4600 Fax(952)249-461G .k' ��goe�' CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL INFORMATION L You may apply for mechanical permits by mail or in person at the City offices. Appiications will be reviewed and a pernut 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 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 modei. 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 Heating Test Record must be submitted before final. TYPE OF PERMIT � �� (Check All That Apply) � ❑Residential ❑ Commercial(Approval Required) ❑ New �Additional ❑ Repairs ❑Replace Job Site/ Owner Information: Site Address: � �� ,(,/'� � � ✓� � �/�/' ' � � �� --� Owner: /V GU�I.�C(/'' Mailing Address: 7�S �•C'rGG/�-L�'�'' �� City: ��l,�h.� Zip: Home Phone: qSa�3��%-3� Alternate Phone: Contractor Information: Contractor: / il,l} �-'C /' � ,I �'� � Contact Person: �U�GJ c� Address: �� l��S 0�� v l��State Bond #: City: Zip: � Expiration Date: Phone: �(�J�7S( 7�� Alternate Phone: � �/ �� ' ❑ Insurance—Current: 1 � � $e�� px��:�,�;��s*'"3��sw�+ �,.. � x � .,�-� �,.. �� c.�a �a} �:�. �.'�';x�. , ., �, � .., � ��. � � � &�� w . � � � . . .,� ,,, ,. ...� . . . � ...�.>—�. �.��<,., . �... e�., ;.,, ,.... ,.. :�. � i., s . . < M......�..: �r�nx.i.�^. • "R Note: All Geothermal Systems will now require a Site Plan &Review by our Building Official. ' IS THIS GEOTHERMAL? ❑ Yes �No � SYSTEMS �^�S�� Quantity: / 1,l �� Make: � Model: a��/" O��QO Fuel: � � � ' / Flue Size: Input BTUs: �� '�-�/ U'�`�� —� 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 VENTILATION ❑ No. Kitchen Exhaust duct recirculating cfin ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank tn place.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside LP Gas: gallons Other: GAS LINE ONLY � � � Outdoor Grill Oth r L�'�`� � ❑ � e /List What&Where: � � � 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: 1. 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 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 $ 5.00 Mail-In Fee (If Applicable) $ 2.00 Total Permit Fee $ PERMIT FEE CALCULATION(S}—JOBS OVER$500.00 � ��t� �� If above does not apply; follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) � �� ' `�� x .0125 $ (contract price) (minimum$50.00) 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$5.00) x .0005 $ (contract price) (minimum$5.00) 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 perniitted 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 pemut 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 times the Contract Price or a minimum of$5.00. MECHANICAL�PERMIT APPLICATION AGREEMENT � ` `��" ��° �� ''r �- The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all work in sh-ict 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: 3 � �, v I D TE TIME CITY OF ORONO CALLED IN 7 � INSPECTION��T�C�E �58� SCHEDULED --�i-,�j� PERMIT NO. COMPLETED ADDRESS a�� S � o c-�'^�I�1 a�2 d,� (,(J OWNER TELEPHONE NO.�?� 3-�5�--7��g CONTRACTOR ' �� C!.�/J >; DESCRIPTION �a-� C 1 �Q- –��i' �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAI 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 ❑ SEPT FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � W a � J O �. � O � W � Q � Z W � W � � � d W �9,WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � � W ❑CORRECT WORK&PROCEED G, ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CQRRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN INSPECTOR W{LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '�CITATION ISSUED � INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: � Inspector. � White Copylinspector's File Canary Copy/Site Notice