HomeMy WebLinkAbout1996-007978 - mechanical .�.
, PERMIT
' CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 #��:f:�:t;t�(T i:�-�i
Crystal Bay, Minnesota 55323 Permit Number: _ _ _
Date Issued: t"''��J'�
(612) 473-7357 t-}c�'�j j'.�F,
SiTE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT-PERMITEE SIGNATURE I ISSUED BY:SIGNATURE
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CITY OF ORONO APPLICATION FOR MECHANICAL PERMTT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within 2 working days.
2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERM�T. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
POSTED ON 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. Identification of and speci�cations for water heating equipment
shall also be 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 473-7357. 24-hour notice required.
7. House Heating Test Record must be submitted before final. V� � "
'�q 1995
Instructions Complete all items on this application. Compute the permit fee. Sign and date �rtifica on.
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 473-7357.
Please check one: New ✓� Addition Repair Replace
✓ Residential Commercial
JUB SIT�: /d Cr .S �ip.A'���Sb
Owner's Name: Telephone Number: �,/7�_ D�i yy
Mailing Address: �C1�m� City: Zip:
Contractor'sName: TelephoneNumber:
MailingAddress: �, � �.._�' ;,�;:� � "�;` �r�r� City: Zip:
HE�T!ti�G F. A!�rn° ���nn4.,�,�r r,p.
SYSTEM DESCRIPTIQ�'`� �,`� '-'� ��� ",'�E so.
rt�� S. t"rF 5542Q�ZP,53
Eg� y�CG
HEATING SYSTEMS
Quantity: /
��.kQ: 1���_�L�L•C s�f r
Model: A/� N �!b
Fuel: �io
� Flue Size: �a ''
Input BTUs: cJo�2�
Output BTUs: �'��
CFM: �-�
;
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H. Power
WOOD BURNING EQUIPMENT
Wood stove with flue
Wood combination or add-on
Factory fireplace with flue
Factory Fireplace (s) Freestanding Masonry
Wood Stove (s) Franklin, other
Brand Name Model No.
Mfgr's Min., Clearances, side, , rear , min. flue dia.
� Total
VENTII,ATION
Nu. Kitchen Exhaust ducted recirculating cfm
No. 3atn �xnaust (must be ducied ouisidej cfL�
No. Other Fans: Locations cfm
Total
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation Removal
Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
/���' x 1.25 $ �s.D I>
(conuact price)
2. State Surchar�e. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $ . �s
(contract price)
3. Posta�e and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ ��'7_3 S
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount chazged for the permitted
work inciuding materials, labor, profit, and other fixed costs. It is the amouut to be charged to the
customer for the work done. Tf any T.,arPri�� PY l��_T_y�,�t, :��o:, c:in:tallati��are iuiiusLeci by tne 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.
** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is
greater.. For valuations over $1,000,000 call the Department of Inspectional Services for the price.
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do
all work in strict accordance with the ordinances of the City and the regulations of the Minnesota
State Building Code, and certifies that all statements made on this application are complete, true
and correct.
Applicant's Signature: � Date: /l-- �Li
��'1.C.E,
Approved By: Date:
..,_,.. ........�. .. t_._.^" ;`{y`:: r ,�r�f:i�.�$�F°'y ;.:r.A��i�;. ,wi. � y,. i'*"s'.i�".{�.7.%�rr�:ibL�k .� rld� .S�^a .f;. j�.f"' n,d*:�f,- s ,. ..
� � t� . . . . . , . � . ... . , � . . � � . . . . � _h�l��� � �
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB NO.
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 • (612) 881-9000 TEST RECORD
ADDRESS CITY
OCCUPANT OWNER
SOLD BY �J..: .. . INSTALLED BY . � .: �(1�
-� 1 �
�o�� �
MAKE MODEL
SERIAL NO._�� � ;` INPUT
THERMOSTAT VENT SIZE
VALVE TYPE OF LINER
LIMIT LINER SIZE
LIMIT SETTING FILTERS: SIZE NUMBER
FAN SETTING WIRING
PILOT TYPE TEST TAG
IGNITION MODEL LIGHTING INST.
PILOT TIMING
DATE TESTED
PRESSURE PERCENT CO2
COMPANY TESTING
�PUT CFH PERCENT OZ
CK TEMP. PERCENT CO NAME OF TESTER
35(REV.11/89) FORM DISTRIBUTION: WHITE COPY-JOB FILE YELLOW COPV-CIN