HomeMy WebLinkAbout2011-00151 - natural gas furnace CITY OF ORONO PERMIT NO.: 2011-00151
2750 KELLEY PARKWAY
ORONO, MN 55356- �AT��ssuE�: 03/10/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 2380 DEVIN LA
PIN : 03-117-23-22-0013
LECAL DESC : THE NURSERY
: LOT OOl BLOCK 001
PERMIT TYPE : MECHANICAL(>$500) �
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL- MULTIPLE
VALUATION : $ 5,900.00
NOTF.: FURNACE-(I)BRYANT 3�SBAU060080-NATURAL GAS-80,000 INPUT BTU'S, 76,000 OU'fPUT BTU'S
AIR-(I)BRYANT 126RNA036-3 TON
APPL[CANT MECHANICAL 73.75
BURNSVILLE HEATING & AIR COND
3451 W. BURNSVILLE PKWY STATE SURCHARGE MECH (VALUATION) 5.00
#120 TOTAL 78.75
BURNSVILLE, MN 55337
(952) 894-0005
OWNER
BLAUER, DARRELL W
2380 DEVIN LA
LONG LAKE, MN 55356-
AGREEMENT ANll SWORN STATEMENT
Che�cork�br���hich lhis permit is issued shall bc performed according to
the approved plans and specitications.applicablc Cit}°ap�rovals,and the
Statc Buildine Code. This permit is for only the work described and does
not grant permission lor additional or related work�chich requires scparate
permits. All provisions of la���s and ordinances governing this type of work
shall be compied with whether or not specified herein.l'his permit�rill
expire and become null and void if construction authorired is not
commcnced��'ithin 180 days of thc datc of issuancc,or if construction is
suspended f�ir a period of I 80 da��s at any time atter work has commenced.
I�he applicant is responsible for assuring a11 required inspections are
requested in conformance�vith the State Building Code."I�his permit may be
rcvoked at any time for e cause.
'-�� � (O / 1/ �� �� � /�
� Applicant Pe tee ig ature Date Is� d y Signature Datc
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
� FOR CITY USE ONLY
p City of Orono
��4 ���� P.O.I3ox 66 Date Received: Permit#
%'� ��`' 2750 Kelley Parkway
t�� �:y'x• �� Crystal Qay,MN 55323 Approved By: Amount S:
� o�' Phone(952)249-4600 Fax(952)249-4616
\J �oy�'�,
`f�
CITY OF ORONO— MECHANICAL PERMIT
(All Commerciul permits must be approved by the Building Ofticial or Inspector and/or Fire Viarsltall)
GENERAL INFORMATION
1. You may apply for mechanical pei-�nits by mail or in person at the City offices. A�plications will
be reviewed and a permit will be issued within two wor•king days.
2. Permit cards will be sent by return mai]after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK VIUST 1\OT BEGIN UNTIL THE
PERMIT CARD IS POSTED Ol�THE JOB SITE.
3. Mechanical Desiens—Complete calculations,details and specifications are required for each
heating,ventilation,hu�nidification-dehuinidification,and air conditioning installarion including
heat loss/heat gain calculation,desi�n temperatures,equipment ratings and identification as to
type,manufacturer and model. Data shali be presented on form provided.
4. When any new construction or remodeling is involved,a separate building pennit must be
obtained.
5. All work must be done in accardance 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 ❑Additional ❑Repairs ❑Replace
Job Site/Owner Information:
Site Address: ���� �,J �r 1 �C��1 C:
Owner:\�e-)C �1(J`Ld,-{'.� Mailing Address: o�3�C� 1�..1C�/ i�1 �
City: ��L�1�) Zip: �`��`��
Home Phone��-���"�13U Alternate Phone: G1SZ -���--�����
Contractar Information:
Contractor: _ � V � �!l�' ���- Contact Person: UU�-
Address: ,�1 �ti �.v�r�v���c' �t.w� State Bond#: 4��Si'��-�-�-1 1�
�
City: �\,�v`�v��� Zip:�1 Expiration Date: � ,��� �
Phone: �2�1�-��.)� Alternate Phone:
� Insurance—Current: S�a�� I l St,��
1
MECHANICAL SYSTEMS BEING INSTALLED
Note: All Geothermal Systems will now require a Site Plan & Review by ow-Building Official.
IS THIS GEOTHERMAL? ❑ Yes �No
HEATING SYSTEMS
Quantity: �
Make: (j��
Model: 3����1(�Sd
Fuel: � �,O
Flue Size:
Input BTUs: c�.1��1�
Output BTUs: 1�;,(��
CFM:
COOLING SYSTEMS
Quantity: `
Make:
Model: ��Q�N�(�3(p
Tons: 3 ��
H. Power '
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILAT[ON
❑ 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 abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where: � �C_ (
2
.
PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
❑ Yes,this secrion applies
The replaceu�ent of a Residential fixture or ap lip ance that meets all three of the following requirements:
I. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less; excludin�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 Permit $ 15.00
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(�biinimum Fee of$50.00)
_ )-1Lx�,(JL�: x .0125 $ ��,���
(contract price) (minimum SSUAO)
2. STATE SURCI-IARGE ** Add the State Bldg Code Div. Surcharge(.14inimum Fee of$5.00)
�OL.I� x.0005 $ -�` �C
(contract price) (minimum$5.00)
3. POSTAGE&HANDLING(Only on Mail-In Applications) � 1�
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �� .��
• * CONTRACT PRICE or JOB COST means the actual or 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 �naterial, equipment, labor ar installations are furnished by
the owner, tenant ar 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 times the Contract Price or a minimum of�5.00.
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:C�,��� Date: 3�-( (
Reset Form 3