HomeMy WebLinkAbout2005-P08817 - gas line inspection PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: po8817
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Pernuts
(952,`, 249-4600 Date Issued: 6/13/2005
SITE ADDRESS: 3385 Crystal Bay Rd Unit#
WAYZATA,MN 55391
P��� 17-117-23-44-0019
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Mechanical Permits Permit Sub-type(s): Gas Line Inspection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Gas Line Only for Fireplace
FEE SUMMARY: Permit Fee: $ 35.00 valuation: $ 2,650.00
State Surcharge Fee: $ 1.33
Misc. Fee: $ 0.67
TOTAL FEE: $ 37.00
APPLICANT: Fore Mechanical,Inc. OWNER: Matthew Bracken
3520 88th Avenue NE 3385 Crystal Bay Rd
Blaine, MN 55014 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE SSUED E3Y SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
FOR CITY USE ONLY
��� City of Orono
P.O.Box 66 Date Receivcd: Pcrmit#
. � ��" 2750 Kcllcy Parkway
��` � � ' Crystal Bay,MN 55323 Approvcd By: Amount$:
�d ��� d`-? (952)..49-4600
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C1TY OF ORONO—MECHANICAL PERMIT
(All Commcrcial permits must bc approvcd by thc Building Official or Inspcctor and/or Firc Marshall)
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will
be reviewed and a permit will be issued within two working uays.
2. Pennit cards will be sent by return mail after a revie�v is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD 1S POSTED ON THE JOB SITE.
3. Mechanical Desi�ns—Complete calculations,details and specifications arc required for each
heating,ventilation,humidification-dehumidification,and air conditioning installation including
heat loss/heat gain calculation,design tenlperatures,equipment ratings and identification as to
type,manufacturer and model. Data shall be presented on fonn provided.
4. When any new construction or remodeling is involved,a separate building pennit must be
obtained.
5. All work must be done in accordance with the Unifonu Mechanical Code/State Building Code
requiremcnts.
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 )
0 Residential ❑ Commercial(Approval Required)
❑ Ncw ❑ Additional ❑ Repairs � Replace
Job Site/Owner Information:
Slte l�Cldl'eSS: 3385 Crystal Bay Road
Owner: Mailing Address:
City: 7ip:
Home Phone: Alternate Phone:
Contractor Information:
COritI'1CtOT: Fore Mechanical,[nc COI1t1Ct peT'SOri: Kevin Grell
Address: 3szo sarn���nUe N.E. State Bond #: �9�/q 3�3
Blaine 55014 g
City: Zip: Expiration Date: �p ��
Phone: (�63)786-6500
Alternate Phone:
❑ Insurance—Current:
1
� MECHANICAL SYSTEMS BEING INSTALLED
HEAT[NG SYSTEMS
Quantity:
Make:
ModeL
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H. Powcr
FIREPLACES
� Gas Factory Fireplace
❑ Wood Burning Fircplace
❑ Wood Stove
❑ Wood Stove With Flue
Pacific Energy Super 27
Brand Name: Model No.:
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfi��
RUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Othcr:
GAS LINE ONLY
❑ Outdoor Griil Q Other/List What&Where: Fireplacc
2
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� � PERMIT FEL CALCULATION(S) � ��
' � BASED OFF - 2002 STATE STATUE I
❑ Yes,this section applies
The replacement of a Residential fixtLire or appliance that meets all three of the following requirements:
1. Does not require moditication to electrical or gas service.
2. Has a total cosC of�500.00 or less;excluding 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-[n Fee(If Applicable) $ 1.50
Total Permit Fee $
� � PERMIT FEE CALCULATION �)�-JOBS OVER$500.00
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$35.00)
�,650.00 x .0125 $ 35.00
(contract pricc) (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x .0005 $ 0.50
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Maii-In Applications) $ 1.50
37.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Abovc) $
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
penliiLted 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 pennit fec purposes. In the evcnt 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.
■ **Thc STATE SURCHAKGE is .0005 of the�3uilding Department at(952)249-4600 for the pricc.
MECHANICAL`PERMIT APPLICATION AGREEMENT
The undersigned hereby applies to the Ciry 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.
Applicant's Signature: l Date: �' �1��
Reset Form
3
�� i��� � E TIME �
�CITY OF ORONO CALLED IN ` �� U.�
INSPECTION NOTIC� �^,� SCHEDULED ��� �
PERMIT NO. G�� b�l � COMPLETED
ADDRESS � � �SJ �f' y�S�r-3� ,�t/ �
OWNER CONTR. � ��G��{� ,
TELEPHONE NO. '���� � ���� ' ���.�O
� DESCRIPTION f� i �' ��--�-�1_.-,�-
l� 01 FOOTING 11 CHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING CHANICAL FINAL D� 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-S�TE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:�YES_NO
� COMMENTS:
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W /ORKSATISFACTORY:PROCEED �PROJECTCOMPLETE
� ❑ CORRECT WORK&PROCEED ,❑ 13SUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. G PHOTOTAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the n inspection 24 hours in advance. (952� 249-46��
OwnerlContr ' e:
Inspector.
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