HomeMy WebLinkAbout2005-P09164 - mechanical PERMIT
CITY Q!� ORONO
Permit Number:
2750 �plley Parkway- PO Box 66 Po9164
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Pernuts
(952) 249-4600 Date Issued:
9/13/2005
SITE ADDRESS: 930 Cox Farm Rd Unit#
Long Lake,MN 55356
PID: 27_118-23-33-0013
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Mechanical Permits Permit Sub-type(s): Heating Systems
DETAILS:
Approved perresolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 0.00
State Surcharge Fee: $ 1.34
Misc. Fee: $ 1.50
TOTAL FEE: $ 37.84
APPLICANT: Select Mechanical OWNER: Mr. &Mrs.Killingstad
6219 Cambridge St 930 Cox Farm Rd
St. Louis Park,MN 55416 Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIF[ED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
`'/Yl�d�t�(. vY�
APPLICANT PERMITEE SIGNATURE SUED BY SIGNATURE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septiq 1-Septic) Page 1
FOR CiT1'liSE OtiLY
/�� Cit}�of Orono �
� P.O.Bo�66 � Date Received: Pzrmit;:
\
'�, o� 27i0 Kelley Park��ay, ,1
� ��� Sp���" �.1/ Crystal Bay,;vi\5>3'_3 � Appro��ed By: Amount S:
�"t 5}��?4.4,G�% (952)_'49'�Ci00 � I
-`�t�exag/
cl��r o� oRo�7a-��EexavlcA�, ����-I�T
(All Commercial pennits musi 6e appru��ed by t;�e Bu;lding Otfcial or Inspecio,and�or ri?�e ltars112ii)
GENERIA.L NFORIVIATIflN
1. 1'ou may apply for mechanical pernuts by niaii or in pei�son at the City offices. �pplications will
be revie���ed and a perniit�t�ill be issued widlin t���o���orking days.
2. Pernut car�-Is w�il1 be sent by retum mail after a revie�v is completed. PER'v1ITS ARE?�OT
��ALID ITNTIL YOU RECEIVE A PERiv1IT. �VORK I�IUST fiOT BEGI\U�`TIL THE
PERi�fiT Cr�RD IS POSTED ON THE.TOB SIT'E.
3. Mechailical Desi�ns—Complete calculations, details�and specifications are required for eacll
]leatinQ, ��entilation,liunudification-dehunudiiication, and air condirioning installation ulcludinn
heat lossiheat gain cakulation, design tenlperattues,equipment ratings and identification as to �
type,manutacturer and inodel. Data sIiatI be pc-esented oci form provided.
4. A�'hen any�ne�v constiuction or remodelin�is invol��ed, a separate building peiz�lit must be
obtained. �� � � �
>; Ail�;�ork nlust be done in accordance with the Uuiform�feclia�iical eode!State Buildin,Code
requirements. �
6. All���ork must be inspected(rou�h-in and fnal). Call(9�21249-=�600.
(?4-48 hour notice required)
7. House Heatina Test Record must be subn�itted before finaL
TYPE OF PERIVIIT
(Gheck All That Apply j �� �
�Residentiai ❑ Comsnercial(Approval Reqt�ired)
❑ Ne�r�� '�dditiotial ❑ Repairs ❑Replace
Job Site/Owner Infornlation:
Site Address: I �J�../ ( '�� '� �f�t�� �`"��`�
O�vner: C�-I�_tS ����--1,In�STA� Mailing Address:
City: Zip:
Hoi�le Phone: r
I Sd�'��- ��f Alternate Fhor�e:
Contraetor Infornlation:� �
Conzractor: �Cl.�%T �t����CsAi.- Contact Ferson: �c.�/AI..C�C.�SP�
Address; ��� ��''�,,�L+D(�'��. State Bond �: �L � ����
City: ST�J�S IM-�e- 7irp:��"��Expiration Date: I �(� (��p
Phone: ��(� -�o�--`t v[�� Altez�late Phane: �1.��- ��,�-�rr�9
�� Instirance—Clirrent: �� ���-f
1
MECHANICAL SYSTEMS BEING INSTALLED
f
.
HEATING SY5TEviS ���
Quantity: ( ' �i���
VTake: �' L�
ModeL• ���'�—���
Fuel: �/�L-���
Flue Size: �/
Input BTL's: 7,S��
Output BTUs: ��P_���_
CFi1�I: �
� �COOLII�G SYSTEIIS
Quantity:
�Iake:
Model:
Tons:
H. Po�ver
FIIaEPLACES �
❑ Gas Factory Fireplace
❑ Wood Bw-nin�Fireplace
❑ Wood Stove
❑ Wood Stove ti�Tith Flue
Brand Name: l�lodel i�io.:
v�ivTrL:�Tiov
❑ No. I�itchen Exhaust duct recirculatine cinl
❑ i\'o. Batli Exliaust(inust have duct outside) efin
❑ 1to. Other Fans: Locations cfm
�'€�EL ST�R4GE(�2UST BE APPROVED BY FIRE 11ARSHALL)
❑ Installatio�l ❑ Remo��al
Fuel Oil: gallons ❑ Unde�ground ❑ Inside ❑ Outside
LP Gas: �alions
Oi11er: y
GAS LI?�E O?�LY
❑ Outdoor Grill ❑ Oiher 1 Lisi�t�hat&�Vl�ere:
�
I • P�RiVIIT�'EE CALGUL.ATI4N(S)
,
' BASED OFF - 20Q2 STATE STATUE
❑ 1'es,this section applies
The re�lacement of a Residential fi�nire or appliance that nieets all three of the follo�ving requirements:
l. Does not require modification to zlechical or gas seivice.
2. Has a total cosc of�500.00 or less; excludin�ihe cost of the finnrre or appiiance: and
3. Is improved,installed or replaced by the homeo�z�er or licensed conhactor.
Skip neht section,if this applies; Cost of Pernut � 1�.00
State Surci�arge � .�0
� � Viail-In Fee(If Applicable} �, � 1.�0
Total Pernvt Fee S
� PERMIT FEE CALCULATION(S)—JOBS OVER SSQO.OQ
If above do�s nat appl�; follo�v guidelines belo��-: -
1. CONTR�CT PRTCE * is 1,Z�°ro of contract price �vitl�a(I1linimum Fee of S3�.00)
,p��PZ>�� x .0125� ���`-�
(contract pricc) (minimiim 53�.U0)
2 STATE SliRCH.�RGE �`*.Add the State Bldg Code Div. Stu�chai•�e(Ztinimum Fee of 5.�0)
���s5 ` � .00Q� � �. 3 �f
(contract�rice) (minimi�m$ .50)
3. POSTAGE �2:HANDLING(Oi�Iy on iY1ai1-In Applicafions) ��� �� � � 1.�0
4. TOT�I:PERitiIIT FEE(Add Lines 1-3 Above) � ���� /
a ? CONTR�GT PRICE or JOB COS-1' means the achial or estimated dollar amount char�ed for the
pemlitted��-ork including materials, ]abor, protit, and other fised costs. Ii is the amotuit to be charged
to tl�e customer for the �-ork done. If any n�aterial, equipn�ei�t, labor or installations are fixnushed by
the o���ner, tenant or any other party, the reasonable markzt value of such iter.is musi be added to the
estimated cost or contract price for pernzit fee purposes. In��the e�•ent that there is a disputa on the
amouut ot the job cost, t]ie City may request the subnussion of a signed copy of the actual contract.
� �*The ST�TE SLRCHARGE is .000� of the Buildin�Depamnent at(9ti2)249-4bOQ for the pnce.
MECHAIvZCAL PERMIT APPLICATION<4GRE.E�IENT
Tl1e undersi�led hereby applies to the Cit_y ior issuance of a itilechanical Pern�it, aorees to do`all
«�orlc in strict accordance �vith the ordinai�ces of the Cirir and "the reaulations of the State of
`Minnesota, and certifies that aIl statements made on this application are complete, true and
'con-ect.
�
�pplicant's Si�iature_ " l�i' � Date: ������
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