HomeMy WebLinkAbout2009-00003 - mechanical , , , CITY OF ORONO PERMIT NO.: 2009-00003
2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE �ssuEn: OU05/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 4060 DAHL RD
PIN : 07-117-23-1]-0020
LEGAL DESC : PIRATES COVE
: LOT 016 BLOCK 001
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHAN[CAL-MULTIPLE
VALUATION : $ 1,665.00
APPLICANT MECHANICAL 35.00
FIRESIDE HEARTH & HOME STATE SURCHARGE MECH (VALUATION) 0.83
2700 FAIRVIEW AVE
ROSEVILLE, MN 55113 TOTAL 35.83
(651)633-2561
Minnesota State License#: 20512060
OWIVER
NEVE, MR&MRS. JAMES
4060 DAHL RD
MOiIND, MN 55364-
AGREEMENT AND SWORN STATEMENT
The work for which this pennit 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 related work which rcquires separate
permits. All provisions of laws and ordinances goveming 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 l80 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 with the State Building Code.This permit may be ���
revoked at any ti ne for due cause. ,
; ,�'���..R, ( l 5 / (3� ` � �� � C �`Y1�ce r � / -_� �9
Appficant Pcrmite Si nalure Date Issued I3y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
�.. ,- .
FOR CIT1 C�E O�L1�' �
���, Cit� of Orono �� �,
.� � ��.
?-0 Box o� � �3��? i
� iJ '� I' �. P3'{.v3. , '' �,�,r,
.� �:� _ �. ,s,�i 3 � `�[��:��� I �ppr� .i 3,� �moun;� I
�
�',� t ' ,�`�i _,�J ��,i0 I
,�N
� ,�...;�„ -�
�R���
CiT�" OF OR�v� - �IECEf�1iCaL PEEZ�IIT
� a.l C�m�rercisi�ernnr mus['o�approsed by'he Quildin;OfSciai�x(n>pec[or an:i��. . -e�larsha'�I��
' GE�ER_-�L ItiFOR�I�TIOti _ I
L You ma;apply tor mechanical permits by mail or in person at the City offices. .�pplications will
be re�,ie�.tied and a permit will be issued within t�co working days.
?. Permi�cards w�ill be sent b} r�rum mail after a review is complet�d. PER��[ITS .�RE tiOT
�'aLiD L�T[L YO�� RECEI��E � PEEL�(IL WORK tiIC�ST�OT BEG[� l��T�L THE
PER�IIT C.aRD [S POSTED ON THE JOB S[TE.
3. LT�ehanical Desi�?ns—Complete ealculations, details and speciTica�ions 3re required [or each
heating, ��n�ilation, humidiTica�ion-dehumiditication, and air condi�ionin� installation includin�
hea[ loss,hea� �ain calculation, desi�n temperatures, equipment r3tin�,s 3nd idzntitica�ion as co
c�pe, manufactur�r and modeL Da�a shall be pr�sented on torrn pro��ided.
�. 4��han an�� re�.v cons�ruction or remodeling is involvzd, a separate buildin�permi�must be
obtsined!
�. �Il work musc b: done in accordanc� with the C,niform�techani�al Cade S�a�e Building Code
r�quiremenr.
6. �11 work must be inspected(rough-in and finalj. Call (9��)1�9-4600.
i 2�--18 hour notice required)
House Hea;in,Test ftecord must be submitted befor� hnal.
� TYPE OF PER�[IT i
! (Check�ll That apply) ��
��f�esi�zn�iai ❑ Commercial (Approval fZequiredl
��,
� \�e�.�� �_�ddirional ❑ (Z�pairs ❑ R�nlace
�� 3ob Site � 0�.��ner Inf�rmation: �
Site :�ddress: ��-S;G ��Q.�►'1L-- ��
0�,��ner: I v Qili Q� � � (�-� '�—" �tailing .�ddress:
Citv: Zip:
Home Phone: " ��� � � �� ��l�rnate Phone:
�, Contractor Intormation: �'i
Con[ractor: ���HomeTechnologies,Inc.
��;�a�aartn & Home Contact Person:
License 205t2060
2700 N. Fairview Ave.
.-���C�»: ctncaville MN 55113 JL3tz B�C1d =:
651 I633-2561
Ci���: Zip: Expiration Dat�:
Phone. .al�ernate Phonz:
❑ Insursnc� - Cumat:
1
• '_, 4 -.
' �IECHatiICAL SY"STEtit� BENG I���I'_�LLED
HE.aTI�G 5�S�E�IS
Quan�itv� �
�ta;�--� ' �U
��i�iode f �
Fuei:
j Fluz 5ize:
Ir,put BT[:s�.
Output BTC.�'s:
CF�L
COOL[�G S��STE>[S
Quann[v:
�take:
�[odei:
Tons:
H. P����r
F[REPL_aCE�
� Ga� Fac�or� Fireplace
�] �L'ood Burnin� Fireplace
❑ ����ood Stove
� ❑ ����od S�ove ��"ith Flue
Brand�ame: ' ���(..� �fodel ��o.:��..�
�E\T[L.�T'[O`
❑ �;o Kitchen Exhawt ducc re;,ircufa�in� cfm
❑ �o. Ba�h Exhaust(must hav� duc�ouride) cfm
❑ tio Otner Fsns: Locations cfm
FCEL �T042.��E ��[C,��ST BE .�PPRO�"ED B�" FIKE ��i.�R�H:�LLj
�,
�; [nst3lla�ion fZemo��af �
Fuel Oil: �alfons ❑ �'nderground ❑ [n�ide ❑ Out�ide
LP Gas: ;aflons
O�her
G_�S L[�� a�LF
I_j Ou�uoor Grili ❑ Oth�r List ����ha�� �:���!��r��. -- —
,
� r .
���, P�R:'��IIT FEE C?�LCUL�-�I'IOti(S) �
' B:�SED OFF - 2002 STATE STATliE
❑ Yes, this section applies
The replacement of a Residentiaf fixturz or appliance that meet;all three of the followin�requirements:
1. Does not require modit'ication to electncal or gas service.
2. Has a total cost of 5�00.00 or less; excludina the cost of the tixture or appliance: and
3. [s improved, installed or replaced by the homeowner or licensed contractor.
Skip next section, if�his app(ies; Cost of Permit $ 1�.00
State Surchar�e � .�0
i��tail-[n Fee�[f.�pplicable) � 1.�0
Total Permit Fee �
' PERI��IIT FEE C�LCULATIO�(S) —JOBS 0�'ER ��00.00 ;
1T abo�.�e does not apply; follow�uid�,lines below:
l. CO�TR.�CT PRICE * is 1.2�°�0 of con�ract pnc� �ti�ith a(�[inimum Fee of�3�.00)
��Q�� „L� x.012� � � �
��oii�rsc[�ricej �:minimum 33�00)
2. ST.�TE SCRCH_�RGE ** .add the Stace Bld�Code Div. Surcharge (�[inimum Fee of�.�0)
I�O�P�J . W r .000� � 1 � �
leonrrsct pnce) (-runimum� �03
3. POST�GE & EI.��;DLItiG(Onlv on ':�[ail-[n Applications) 5 �0
�. i'OT.aL PEIZ�I[T FEE (.add Lines l-3 .�bove) � �� • ���
■ { CONTR.�CT PRICE or IOB COST means the actual or estimated dollar amount char�ed for the
permitted work includin� materials, labor, profit, and other fixed costs. [t is the amount to be charged
to the customer for the work donz. If any material, equipment, labor or installations are furnished by
the owner, tenant or any other party, the reasonable markzt value of such items must bz added to the
zstimated cost or contract pnce for permit fee purposes. [n the e�ent 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.
� ** The STATE SURCHARGE is .000� of the Building Department at(9�Z)2�9-�3600 for the pnce.
� MECI�?�NICAL PER�vIIT APPLICATION AGREEIVIEIv�T j
The undersi�ned hereby applies to the City for issuance ot a i�lechanical Permit, a�rees to do all
w�ork in strict accordance with the ordinances of the City and the re�ulations of the State of
�Iinnesota, and �.ertifies a[ ail statements made on this applica[ion are complete, true and
correct.
� �_ � ,��
_�pplican�'s Si�nature: Da�e:
,
�
� �(� o�� ���z �
�1/�t11 � QA IE�� TIME
,�CITY OF ORONO ��� CALLED IN =�
INSPECTION NOTICE��� SCHEDULED �
PERMIT NO.� � COMPLETED
ADDRESS 1
OWNER CONTR. ���...Si do_ �.�'cl1C��
TELEPHONE NO. ��.�� ��`�� � �a 3� � ��
� DESCRIPTION � � ��l ��--� �f �1 �C�
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
� WALL BD. ❑ WATER HOOK-UP
Z ❑ ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
J ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
�
�
O
a
�
O
�
W
�
Q
�
Z
W
�
W
�
�
GW ❑WORKSATISFACTORY:PROCEED �PROJECTCOMPLEfE
� ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952) 249-460�
OwnerlContractor on site:
Inspector. Ta��/1� �
White Copyllnspector's File Canary CopylSite Notice