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Home My WebLink About2014-00641 - cooling systems CITY OF ORONO * 2 0 1 4 - 0 0 6 4 � 2750 KELLEY PARKWAY DATE ISSUED: 06/23/2014 � ORONO, MN 55356- � (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 450 DF.BORAH DR PIN : 31-118-23-23-0008 LEGAL DESC : MCCULLEY FARM : LOT 005 BI_OCK 002 PERMIT TYPE : MECHANICAL (> $500) PROPERTY TYNF, : RESIDENTIAL CONSTRUCTION TYPE : COOL[NG SYSTEMS VALUATION : S 4,899.50 NO"I'I:: 1 KI�:NMORI�;-1�I�UN ,1C� APPLICANT MECHANICAL 61.24 STATE SURCHARGE MECH (VALUATION) 2.45 KNIGH"I' HEA"I�ING& A[R COND MAIL-IN FEE 2.00 13535 89T'H ST NE OTSEGO, MN 55330 TOTAL 65.69 (763)274-9945 Payment(s) CtiECK 10351 65.69 OWNER BIESTERFELD, ROBERT 450 DEBORAH DR MAPLE PLAIN, MN 55359- AGREEMENT AND SWORN STATEMENT l�he work for H°hich this permit is issued shall be perRxmcd accordine to the approved plans and specifications,applicable City approvals,and the State I3uilding Code. This permit is for only the work dcscribed and ducs not grant permission for additional or related work which requires separate permits. nll provisions of laws and ordinances governing diis type of work shall he compied with whether or not specified hcrein.This permit will capirc and becomc null and void if construction authorized is not commenccJ within 180 days of the date of issuance,or if construction is suspendcd for a period of I 80 da}�s at any time after work has commenced. �I�he applicant is responsible for assurinc all required inspections are requested in conformance with the State Building Code.This permit may be rcvokcd at any timc for duc cause. / / Applicant Permitee Signtiture Date Issued F3��Signature Date �� FOR CITY U5E ONLY % O � City of Orono � � N P.O.Box 66 Date Received: Permit# j O 2750 Kelley Parkway �' Crystal Bay,MN 55323 Approved By: Amount$: Phone(952)249-4600 Fa�c(952)249-4616 -a �, i ZF ; . �qk�sN��`' CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official or Inspec[or and/or Fire Marshall) GENERAL INFORMATION 1. You may apply far mechanical permits 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 after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED 01�1 THE JOB SITE. 3. Mechanical Designs—Complete calculations,details and specifications are required for each 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 submitted before final. TYPE OF PERMIT (Check All That A 1 �Residential ❑Commercial(Approval Required) ❑ New ❑Additiona] ❑ Repairs ,�Replace Job Site/Owner lnformation: Site Address: �� -e�QYG�-I'1 ��,�J Owner:�� YJPfi� �/�S�C�"-�d Mailing Address: `7�v ��yal�I. ��' ciTy: �/Ir�,�l�Pla;,�., .�M�I z�p: � �s� Home Phone: �5a�- �7,�j � OZv�3Alternate Phone: Contractor Information: i k-� Contractor: c• Contact Person: I j e Address: I�S 3S'8��1 S�'•/�� State Bond#: � IV�3 � 3 I U 3 City: 0 IV Zip:,�3�xpiration Date: �—/-�� ' Phone: �3��`��`-�s AlternatePhone: ❑ Insurance-Current: 1 MECHANICAL SYSTEMS BE1NG 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: Input BTUs: Output BTiJs: CFM: COOLING SYSTEMS Quantity: I Make: Model: C�3`f o�/�-� Tons: H.Power FIREPLACES ❑ Gas Factory Fireplace Brand Name: ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTILATION ❑ No. Kitchen Exhaust duct recirculating cfm ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (Must be approved by Fire Marshall if proposing to a6andon 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 applies The replacement of a Residential fixture or ap�liance that meets ali 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;excludinQ 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 Pernut $ I5.00 State Surcharge $ 5.00 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: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) ��9', SD X.oi2s$ �/• �-� (contract pricc) (minimum$50.00) 2. STATE SURCHARGE �� /c • x .0005 $ 7 J contract pricej 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMTT FEE(Add Lines 1-3 Above) $� }� / ■ * CONTRACT PRICE or JOB COST means the actuai ar 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 for the work done. If any material, equipment, labor or installations are fucnished 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 that all statements made on this application are complete, true and correct. Applicant's Signature: Date: '� �/ 3 '`�� CERTIFICATE OF LIABILITY INSURANCE i2i9i2o�' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES `BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORI2ED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate dces not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT T1m Anderson NAME: Nesbit Agencies, Inc. PHONE . (g52)873-2737 FAXN :(952)873-2268 124 West Main E'�� .tanderson@nesbita encies.com AD R g INSURER S AFFORDING COVERAGE NAIC# Belle Plaine l�i 56011 iNsuReRn:Secura 2543 INSURED INSURER B: Knight Heating & Air Conditioning, Inc. iNsu�Rc: 13535 89th Street NE INSURERD: INSURER E: Elk River NIld 55330 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1312932955 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 7ypE OF INSURANCE L POLICY NUMBER M D Y EFF M�LIpCY EXP ��M�� LTR GENERAL LIABILITY EACH OCCURRENCE S 1�OOO�OOO X COMMERCIAL GENERAL LIABILITY PAEMISES a occurte�ce 5 lOO,OOO A CL/+IMS-MADE �OCCUR OTC003156801-3 2/B/2013 2/8/2014 MED EXP(Any one person) $ $,000 PERSONAL 8 ADV INJURY $ 1�OOO�OOO GENERAL AGGREGATE b 2�000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2�OOO�OOO X POLICY PRO- L� g AUTOMOBILE LIA&LITY COMBINED INGLE LIMI Ea accident 1 000 000 A ANY AUTO BODILY INJURY(Per person) b ALL OWNED X SCHEDULED 156802 2/8/2013 2/8/2014 gODILY INJURY(Peraccident) 3 AUTOS AUT0.S PROPERTY DAMAGE $ X HIREDAUTOS X q�7p�ED Peraccident PIP-Basic $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE y S,OOO,OOO A EXCESS LIAB CLAIMS-MADE AGGREGATE 3 1�OOO�OOO DED X RETENTION$ 10,00 OCU003156803-3 2/8/2013 2/8/2014 $ WORKERSCOMPENSATION O FOLLOW DIRECT FROM WCSTATU- OTH- AND EMPLOYERS'UABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y� N�A ERKLEY RISK E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPER.4TIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,tt more space is requiretl) CERTIFICATE HOLDER CANCELLATION (952)249-4616 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ci.ty Of OTOIIO ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 66 27Jr0 Kelley Parkway AUTHORIZEDREPRESENTATIVE Crystal Bay, L�T 55323 Tim AndersOn/TA �� _�'��-'-�-- ACORD 25(2010/05) OO 1988-2010 ACORD CORPORATION. All rights reserved. INS025 r�n�nn�i m Thc A(:�1RIl n�mc�nrl Innn�rn roniaFu�nri m��4c nf A(`ARI1 � � DA/T.� TIME � CITY OF ORONO CALLED IN -� INSPECTION NOTItC/E SCHEDULED 7-1�-��F __C?�' PERMIT NO.�� 7— �v�yl COMPLETED ADDRESS �SO �(J�U�-�- �v OWNER Ob � l��S��CI�ELEPHONE NO.��o3 Z7� ��S CONTRACTOR ��C�N�-�- � � � �L`'��_ >; DESCRIPTION �� C' � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: a �C 2eDl�ccc.+leti� -' � J O '' ' P_le�}►-�c4C re�o�+�.�C�' �- � O � 1 � � 20��'t •,�s � �!L�2.t�'r/ ��e ��cv n 1Qc.� � Q z ,�o� c< cd M� ��fe W � � �q�2/�,-�� tr�/a� � GW ❑WORKSATISFACTORY:PROCEED �OJECTCOMPLEfE � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �� CITATION ISSUED O INSPECTION REQUIRED.CA�I TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� 249-46�0 OwnerlContractor on site: . Inspector. White Copyllnspector's File Canary CopylSite Notice