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Home My WebLink About2012-01139 - heating system ` CITY OF ORONO * z 0 1 z - 0 1 1 3 9 * 2750 KELLEY PARKWAY DATE ISSUED: 1 U08/2012 t ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3435 CRYSTAL BAY RD PIN : 17-117-23-43-0120 LEGAL DESC : W[LEYS PARK LAKE MTKA : LOT 003 BLOCK 001 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : HEATING SYSTEMS I VALUATION : $ 3,400.00 NO"I'I;: 1 CARRIER Nn"I�URAL GAS FURNACE , � APPLICANT MECHAN ICAL 50.00 CENTER POINT ENERGY M[NNEGASCO STATE SURCHARGE MECH(VALUATION) 1.70 9320 EVERGREEN BLVD NW SUITE B MAIL-IN FEE 2.00 COON RAPIDS, MN 55433 TOTAL 53.70 (763)757-6202 OWNER BROWN, SCOTT 3435 CRYSTAL BAY RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall bc performcd according to the approved plans and specifications,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 eonunenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance wiU�the State Building Code.This permit may be revoked at any time for due cause. / / / / Applicant Permitce Signature Date Issued E3y ' nature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. ✓ ��,�� .v FOR CITY[iSE ONLY . %:-°'�y""�"p��, City of Orono � P.O.Box 66 Date Recei�ed: Permit# i��:;,;,, �`i'I 27�0KelleyPar{cway l��y a+y'��..•.`. `�r �rystal Bay,MN�5323 Approved By: Amount S: `�\��:��f�, Phone(952)249-4600 Fac(9�2)249-4616 �_� CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits must be approved by the Buildin¢Official or Inspector and/or Fire Mazshall) GENERAL INFORMATION 1. You may apply for mechanical permits by mai]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 retum mail after a review is completed. PERMITS ARE NOT VALID LTNTIL YOU RECENE A PERMIT. WORK MUST NOT BEGIN t1NTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanica] Desi�ns—Complete calculations,details and specifications are required for each heating,ventilation,humidification-dehumidification,and air conditionin�installation including heat loss/heat gain calculation,desion 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 permit must be obtained. �. 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 Heatin�Test Record must be submitted before final. TYPE OF PERMIT (Check All That A 1 ) �esidential ❑ Commercial (Approval Required) ❑ New ❑ Additional ❑ Repairs ❑ Replace Job Site/Owner Information: Site Address: 3� 3� C�t��` ��=�� \�CA-s�-{ �d, Owner: JCL�� G�?1'1 MailinQ Address: 3y�J`J �ruS�� y �� City: �`.!C��C;� Zip: _ `�� `��1 � Home Phone: �`� ,�- - ,� � L` � �� Alternate Phone: Contractor Information: CENTERPOINT ENERGY JOANN ZINKEN Contractor: Contact Person: 9320 EVERGREEN BL STE B 2201 3346 Address: State Bond #: City: COON RAPIDS Zlp.55433 Expiration Date: OHI2O/� 2 Phone: �763� 785-5404 Alternate Phone: Travelers Indemnity Company Workers Compensation&Employers Liability ❑ IriSUt'ariCe—CUt7erit: Policy#TC2K-UB_93498101 1 Policy Period O1/O1/2012-01/O1/2013 r MECHANICAL SYSTEMS BEING INSTALLED . Note: All Geothermal Systems will now require a Site Plan&Review by our Buildin;Official. IS THIS GEOTHERMAL? ❑ Yes �No HEATING SYSTEMS Quantity: ( Make: �C.�-r't��F��p Model: `7r ��j�(�r;(.�' Fuel: ��'t��r"��.��J Flue Size: Input BTUs: �.�L=jC�C�=�� Output BTUs �� , �-C_`C, CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: H.Power FIREPLACES ❑ Gas Factory Fireplace Brand Name: ❑ Wood Burning Fireplace ❑ Wood Stove Iviodel No.: ❑ Wood Stove with Flue/Nlasonry VENTILATION ❑ No. Kitchen Exhaust duct recirculating cfin ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (_�Llust be approved by Fire Marshall if proposing to abnndon tank in place.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑Inside ❑ Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List What&Where: 2 a PERMIT FEE CALCULATION(S) BASED OFF -2002 STATE STATUE ❑ Yes,this section appiies The replacement of a Residential firture 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;exctudinQ the cost of the fixture or appliance: and 3. Is improved,installed or replaced by the homeo�vner or licensed contractor. Skip next section, if this applies; Cost of Permit $ 1�.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ PERMIT FEE CALCULATION(S —JOBS OVER $500.00 1 If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of��0.00) 3�-� LC� . C�� x .oi2s $ �C� ,c,�c-� (conrract price) (minimum S�U.00) 2. STATE SURCHARGE � � ��C:�• — -- x .0005 $ J � � (contract price) 3. POSTAGE&HANDLING(Only on ivlail-In Applications) $ 2.00 4. TOTAL PERII�IIT FEE(Add Lines 1-3 Above) $ j J •• �� ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charQed for the permitted work includine 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 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. 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 t all statements made on this application are complete, true and correct. Applicant's Signature: l 'L']/y � s ��'Date: r� �� / Z / �`._ i � Reset Form� � 3