HomeMy WebLinkAbout2010-01072 - mechanical , � CITY OF ORONO PERMIT NO.: 2010-01072
2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE �ssuEu: 1U0U2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 250 CYGNET PL
PIN : 04-117-23-23-0018
LEGAL DESC : SWAN LAKE ADDN
: LOT 009 BLOCK 003
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 6,450.00
NOTI;: 1�EA"CING SYSTEM-(1)CARRIER-NATURAL GAS-2" PVC FLUG
COOLING SYSTEM-(1)CARRIER-2 TONS
APPLICANT MECHANICAL 80.63
DITTER INC. STATE SURCHARGE MECH (VALUATION) 5.00
820 TOWER DRIVE
MEDINA, MN 55340 TOTAL 85.63
(763)478-9558 PAID WITH CC# OOSI
OWNER
BROWNLEE, MR. & MRS. JAMES
250 CYGNET PL
LONG LAKE, MN 55356
AGREEMEI�IT AND SWORN STATEMENT
"I�he work for�vhich�his permi[is issued shall be performed 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 rela[ed work which rcquires 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
commenced 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 conYormance with the State Building Code.This permit may be
revoked at any time for due cause.
��,J r {•"'
<1' iL.�r—�:�� � %l / v� l %� �— �� � � / l /�
Appli�ant ermrt e Signature Date Issued Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE.
11i01i;010 12:42 DITTER INC � 9522494616 N0. 113 D02
/� ^ a�o7 i�
rc� CI Y US�ONGY
Cit�of Orono (� ���� �Q �
4�'��� P,0.11ox66 pn�eRec�ivecl; � �U Permi�#
' 2750 Kelley Pncl�way
�`4 r Crysr�l 13ay,MN 55323 Approved Hy. Amount S� � �
����'�,6� Phonc(�I�Z)z�9-4600 rax(953)249-461G
�
CITY OTi" ORONO—1ViECHANICAL P�RMIT
(All L'umin�rcial pennits mus�L�e,�pproved by�ho Build.ing OCi'ici�l or fnspeetor ancl/or Pira Mnrshall)
I
GENERA�� INT'ORM�tT10N
1. You m�y 2��ply for mechanica,l��ennits by�ro.�il or in person�r the Ciry offices, Applications will �
bc revier�ved and�permit wi.11 be issued witl�in lwo workin6 days.
2. Permit cards will be sent by retum mail after a reviowv is com��leted. Pf 1tMTTS ARG NOT
VAUYI�YJNTIL YQU IL�C�7VG A PERh!11T. ''4'�4RK MUST NOT 13�C,1.N �1NTTL TH�
PERM[T CARD XS PO�TED dl�TTTr JOD SITE.
3. M.ech�nie�l Des�����—Complete e�lcula.tions,desails flnd specifications are required for eRch
Itie�tin�,ven�it�tion,l�umiclification-dehumiclifcation,�nd air conditioning ii�stallation including
he�t loss/1�eot�1in calculation,desi6n temper�tures,equinment r�tings and.identifcation as to ,
iype,menufacturer a.nd model. 17ata shall be presented on form provided.
4. When any oew constrvction or re.modeling is invol�ved,�►separate builtl.ing permit must be
obt�incd.
5. All worlc must be done in a�ecorclance with the Uniform Mechaa�ical Code/State Huilding Code
reyu i remencs.
G_ All work muSC be inspoctcd(rougl�-in and finllj. CaU (952)249-�1G00.
�24�48 hour nocice rec�yiired)
7. T�c�use T-lea.ting Test Reeo�d musc be submitteci before fin�l_
TY}'�' 4F PERMTT
Cl�ecic All That A 1
�sidenti�l ❑Com�rercial(Approval REquirec�)
❑ New ❑ Addicional ❑Repairs Replace
Job Site / Ownc�• Ini'orm�tion:
Site Address: �S° CY�"'�`� ��`'`G
Owner: Lo+'S ��arJM /� �(�ilingAddress: �So CYq hP� ��
Gity: �v'orv Zjp; SS3SG
Ho.me Pl�oiZe: �S2` ���- z S9g Altern�te Pho7�e: �
Concractor Inlorialati�n,
�j;FF�n- Go�/i,� ���`Co��'ii�ct Person: ����'� �'"�`��
Contr�c�or: _ _
�cldress: flZ° %0:✓�� �r- State Bond#: L`�'7'`+�6 SD
City; ��� �ip:,Ss��Cxl�iration DAte:
Phone: 7G3-�✓7P -'�ss�' Alternace Pltione:
[] lnsurance—Currenl: S t"¢< '���o
l
11i01�G010 12:42 DITTER INC � 9522494616 N0. 113 D03
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,,, ��� ,. �� S. �. NS�'.<1 '��;Ll7u ; , . ,,,.
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Note: All Geolherr�nal Syslems will no'w rec�uire a, 'te Pla,n & eview by our Duild'tng Orficial.
1S T�rI1S GEOTC�CRMA►L? ❑ Yes Q No
C��ATING SYST�MS �
I�
Qunnciry; 'I
Make: �G✓r t-[�'
Nlodel: S�'�nveod0
Fu��: NP�����'�
Plue Size: 2�� 1���
input I3TlJs: .0�� �
o�►tr���c Dr�S:
7G�moo �
CFM: �� .�-7•`�
COQ�ING Sl'STCMS I
Qu�Lntily; �
Make: (rAr ri E� _
Model: a'�'�'��'L�
Tans; a�
!'o,dS
I-I..Povver
FTRC_pLACFS
Gas f a.ctary �irepllce Drantl Name:
Wood I3urning Firepllce
'VJoocl Stove Model No.:
V�Jood Stove With�'lue
VENT��.r�T10N
No, hitehen Gxhaust duet recircula�ing cfir
No. 13ath Exh�ust(n�ust have duct ou'cs:ide) cfrn
No, Other F�ns: Locations cfm
TUFL STa7tAGr. (A9r�sr be apprvvec!b��Tire il�nrsh�rl!if�roposl�tg tQ Rhondon tAnk lr�plo�e.)
� I.nst�ll�tion � Removal
1=ue1 Oil_ gallons ❑ Under•ground ❑ inside ❑Outside
C,P Gas: ballans
Other;
GAS I.CN�ONLY
� nu�door Grill � Othcr!List WI�At&Where: „_
2
11i01i2010 12:42 DITTER INC � 9522494616 N0.113 D04
'irl.�l •. ;f M1• � `:I �+ r����'� �Y� v� r'� ' I a � , � , I(.
�l N �� f � ���Y����� `���"'1 ,M1 d � �� d ��d� �,,,� � �n, .
I� +.o�f��.����M��" ��� �' �! ,.0 ,� � `'E " ���',� n�� w '�',. '� f N"r.11�'ti.
� Yes,chis sectioo applies
'�l�e:replacement oi�a Residenli�tl �ixtu��e�Fl;pLli�.nce that.meets flll I;hree ofthe following requirements:
1. Dee�noc reqwire rnodiFica,tion to electrie�,l or g�.s service.
2, Has a tot�l cost o:f$SOb.UO or less;excludin�Che cosC of�l�e fixture or appli�nce:and
3, Is im��roved, installed or replflced by tl�e homeowner or licensed contractor_
Skip next section,if this t�pplies; Cost of.Pcrmii $ 1 _00
St�te Surchargo � 5.Q0
Mail-Tn Fee(lf ApplicAble} $ 2.Q0
ToCrl Pcrrnit Fec $
„
��:���� 1� ..�,� P�R:�rl�r:�. C�:��� ��r r� .�� ,,a ��oo: u�. ;,;�,
,,A � ��, ;�
if above does not�pply;follow 6uiclelines belo�r:
I, CONTRA�CT PR.CC� * is 1.25"/0 of contracc price�rrith a(Minimum Eee ot�5a.00)
�, ySo•pO x .o�,zs $ 80��3
(controcC price) (minimum$50,00)
2. STAT�SURCH�RG1: °�"' Add tlze Sta:�e flldg Cod.e I�iv. Surcharge(Min�mum I'ce of�5.06}
��`5� x ,0005 $ Soo
(canaacf prico) (minimum S 5,00)
3. POS7'AC�&l�fi�NDLTNG(Only on fviail-In Aryplic4tions) � �_
4. T07'A.L PG)tMYT r�E(Add Lines I.-3 Above) � 8S��
• " CONTRACT !'RICC or JOB COST means t�he nctu�.l or estin�a.ted d.ull�r amount charged for the
permitted worl: ineluding m�teri�ls, labor,�ro'rc, flnd otl�er fixed costs. Tl is the a��iount to be al��rged
�o the customer ('or che worlc clo�,e. 11'any maleri�l, eq��ipment, la.bor or insc�lJatians are furnished by
the owner, tennnt or�ny other party, the reason.able m�.rket value af such icems must be aclded to the
estii�nated cost or cantr�cf price for pennil fee p�►rposes. in d�e event th�t Chere is a dispu�e on the
amount of the job cost, �he Cit� may i•ec�uest the submission of s si�ned copy of the actufll contrac�.
■ ""'The ST�IT�SURCHARGE is.0005 times the Contract Price or a minim�nn of$5.00.
��: ., ,,, M�CGH�N1�^�lL,,l��lL,,�� ,a,a��' ;�,�.l:l(�� GR �� � �� y�G �;�;� ,�
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Tlie �mdersigned )�ereby a}�plies to tlie Ciry for issu.ance o1't�N[ecl��nical Permic, agrees to do �lt
work in strict flccorclance with th.e ordir�ances o9' che City and the regulations af the State or
Minnesota, and ceitiif�ies tl��t �tll statemencs ma.cle on illis applica�i�n are complete, U1.te and
correct.
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Applicaixt's Si�n�ture: `�� ^ bate: f //
�'�t.e' _ 'F o�,'"��,� 3
.�� //DA�f TIME �
CITY OF ORONO CALLED IN �'
INSPECTION NOTICE SCHEDULED ` -/� �
PERMIT NO.�D�O Q�o�a, COMPLETED
ADDRESS 0.��D C�QlN��Z ��
OWNER TELEPHONE NO. ��3 �7a �-rY
CONTRACTOR ���
j; DESCRIPTION /'Z�Ci�� �"�
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ 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. ❑ FOI.LOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ Fi�RD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE
W ❑CORRECT WORK&PROCEED '= ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR n CITATION ISSUED
❑ INSPECTIOfV REOUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46QQ
Owner/Contractor on sit : �
Inspector. r� �
White Copyllnspector's File Canary CopyiSite Notice