HomeMy WebLinkAbout2012-01128 - gas line only � CITY OF ORONO * z 0 1 z - 0 1 1 2 � *
� 2750 KELLEY PARKWAY DATE ISSUED: 1U06/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2755 DEER RUN TR E
PIN : 04-117-23-13-OO14
LEGAL DESC : CRYSTAL BAY PRESERVE
: LOT 007 BLOCK 001
PERMIT TYYE : MECHANICAL(>$500)
PROPERTY TYPE : RES[DENT[AL
CONSTRUCTION TYPE : GAS LINE ONLY
VALUATION : $ 500.00
NOTE: GAS L[NE FOR S�I�AND 13Y GI�,NI;RA"I'OR
APPLICANT MECHANICAL 50.00
MECHANICAL AIR SYSTEMS STATE SURCHARGE MECH (VALUATION) 0.25
1473 91ST AVE.NE
BLAINE, MN 55449- MISC FEE 0.00
TOTAL 50.25
PA[D WITH CASH 50.25
OWNER
STAHL, PETER
2755 DEER RUN TR E
LONC LAKE, MN 55356-
AGREEMENT AND SWORN STATF,MENT
The work for which this permit is issucd shall be performed according to
the approved plans and specitications,applicable City approvals,and the
State Building Code. This permit is for oniy the work described and does
not grant permission for additional or related werk which r��quires separate
permits. All provisions of laws and ordinar::es goveming this type of work
shall be compied with whether or not speci?icd herein.'fhis 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 time attcr work has commenced.
'Che applicant is re onsible for asSuri� all required inspections are
requested in ormance with the.' ate I3uilding Code.This permit may be
revoked any time for due causc:'
/�j ✓ ! �
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' Ap icant ermi .ignature Date Issued 13y Sig a re Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
FOR CITY USE ONLY
�` City of Orono
O4O`VO P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
�a f �' Crystal Bay,MN 55323 Approved By: Amount$:
��� E�� Phone(952)249-4600 Fax(952)249-4616
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CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or lnspector and/or Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical pernlits by mail or in person at the City offices. Applications will
be reviewed and a pennit 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 RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical DesiQns—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 fonn 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 ❑Coinmercial(Approval Required)
❑ New ❑� Additional ❑ Repairs ❑ Replace
Job Site/Owncr Information:
s�te aaar�sS: 2755 Deer Run Tr.
oW„er: Peter Stahl Mailing Address:
c,ty: Orono zip:
Home Phone: Alternate Phone:
Contractor Information:
Mechanical Air Systems Tim Rancour
Contractor: Contact Person:
Address: 1473 91st Ave. Ne State Bond#: TMB647CO7
Blaine 55449
City: Zip: Expiration Date:
Phone: (763) 464-6502 Alternate Phone: (763) 424-4226
❑ Insurance—Current:
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MECHANICAL SYSTEMS BEING 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 BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
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) cfin
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel OiL• gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ otner�L�st what&where: Stand by generator
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PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirenlents:
1. Does not require modification to electrical or gas service.
2. Has a total cost 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 Pennit $ I 5.00
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)
x.0125 $ ��.��
(contract price) (minimum$50.00)
2. STATE SURCHARGE
x.0005 $0.5�
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $��.��
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar ainount charged for the
perinitted work including inaterials, 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 that all statements ad � this application are complete, true and
correct.
Applicant's Si r . Date: � �/O5/�2
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