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Home My WebLink About2009-00919 - gas line only CITY OF ORONO PERMIT NO.: 2009-00919 � 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE �SSUEn: 12/29/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 290 CRESTV[EW AVE PIN : OS-117-23-14-0018 LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK : LOT 000 BLOCK 001 PERMIT TYPE : MECHANICAL(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY NOTE: ADD 2 HEAT SUPPLYS TO F,XISTING DUC"I'WORK FIREPLACE GAS LINE APPLICANT MECHANICAL(<$500) 15.00 C & M PLUMBING & HEATING STATE SURCHARGE MECH (<$500) 0.50 610 CENTRAL AVENUE BUFFALO, MN 55313- TOTAL 15.50 PAID WITH CASH 15.50 OWNER HOCHSTEDLER, SCOTT 290 CRESTVIEW AVE LONG LAKE, MN 55356- ACREEMENT AIYD SWORN STATEMENT 'I�he work for which this pennit is issued shall be performed according to the approved plans and specitications,applicable City approvals,and the Sta[e Building Code. This pennit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This pennit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construc[ion is suspendcd for a period of 180 days at any time atter work has commenced. 'The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any tiipe for due cause. � y� �� `' � �% �y� c� � r.=" ;c"'�r � '% ':=':- i r / l l App ical nt Perruitee Sig�aCure Date Issued By Sig ure Date SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV � � � FOR CITY USE ONLY ,�� City of Orono O O� P.O.Box 66 llate Received: Permit# � �,,�,,,, 2750 Kelley ParkH�ay a �j4�'`�;��` � Crystal Bay,MN 55323 Approved By: Amount$: ��9 ��#�%' ti �" '�'�. �.a (952)249-4600 {,�k��'��4� E9H� CITY OF ORONO-MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official or Inspcctor and/or Fire Marshall) GENERAL INFORMATION 1. You may apply for mechanical pernzits 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 af�er a review is completed. PERMITS ARE NOT VALID UI�'TIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Designs—Complete calculations, details and specifications are required for eacb 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 subnutted befare final. TYPE OF PERMIT (Check All That Apply) �Residential ❑ Commercial(Approval Required) ❑ New �dditional ❑ Repairs ❑ Replace Job Site/ Owner Information: Site Address: � y D C�h�'�� Y �c�f � U'-� � Owner: �C Q � I-�o�h 5'l�d� �-� Mailing Address: �� -c. City: �/�D i✓'� Zip: Home Phone: �� 7-3` �1'`�� Alternate Phone: Contractor Infornzation: Contractor: ��j 11�1�� »�U- -�- ��''L Contact Person: �� Address: � �D �.�,,/��-�.L A�`?State Bond #: �; y �/�y� � City: �.�-l�/�/a Zip;�"��j3Expiration Date: �/�/� �� Phone: 7�.��- ��y'c� Alternate Phone: ❑ Insurance-Current: 1 r � 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: � � � — ��,� � �!.c �� 2� ,S ��. Input BTUs: � o �� .' yC � � ✓-/��. It.-�u C '� �v �� 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 VENTILATTON ❑ Na Kitchen E�aust duct recirculating cfin ❑ No. Bath E�chaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STOItAGE (Must be approved by Fire Marslxall if proposing to abandon tank iiz place.) ❑ Installation ❑ Removal Fuel OiL• gallons ❑ Underground ❑ Inside ❑ Outside LP Gas: gallons Other: GAS LINE O�LY � •h� ��I� C-� C u l-� �-� ��'- �— ; ❑ Outdoor Grill ❑ Otl�er/List What&Where: 2 A . ' 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 ion to electrical or gas service. 2. Has a total cost $500.0 or less; excludin�the cost of the fixture or appliance: and 3. Is improved,installe 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 Total 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 contract price with a(Minimum Fee of$50.00) x.0125$ (contract price) (minimum$50.00) 2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50) x.0005 $ (contract price) (minimum$ .50) 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 far 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, tbe City may request the submission of a signed copy of the actual contract. ■ **The STATE SURCHARGE is .0005 of the Building Deparmlent at(952)249-4600 for the price. MECHANICAL PERMIT APPLICATION 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. ��'�� /7 L. 2"/L`C Arplicant's Signature: p� r ,� J��f Datc: �o��1n—� � 3 __�__ ----______ _, _ Certificate � f�11hNESCITA DEPARTMENT C7� Mechanical Bond �BOR g� �HpUSTRY 443 Lafayette Road N St Paul,MN 55155 :+ and Certification Services hone: 651-2845898 d��mn,Qo� E-mail: DLI Lfcense��te�mn.us TQ1eP h 11I1312010 Construction Codes and Licensin9�'��5�� icenstng 3268�9�for the period 11/1312009 throug Website: wvvv+._----- This is to certiN that the certifi'acon°adt ng in all�areias of the state of Minnesotaes§ - and may engage in mechan�ca Cg�j{jCBte ID. 3954-MB C8�M PLUMBING HEATING AND AIR CONDITIONING INC 610 CENTRA�AVE BUFFALO,MN 55313 Effective Date: 1111312009 Bond ID: 69615958 Expiration Date: 1111312010 WESTERN SURETY CO