HomeMy WebLinkAbout2012-00614 - gas line only CITY OF ORONO * z 0 1 z - 0 B 6 1 4 *
2750 KELLEY PARKWAY DATE ISSUED: 06/28/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 114 CHEVY CHASE DR
PIN : 36-118-23-41-0035
LEGAL DESC : HILL O'WAY MANOR
: LOT 001 BLOCK 002
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RES[DENTIAL
CONSTRUCTION TYPE : GAS LINE ONLY
VALUATION : $ 920.00
NOTE: RUNING GASLING POR FIREPLACE
APPLICANT MECHANICAL 50.00
SAYLER HEATING& AC STATE SURCHARGE MECH (VALUATION) 0.46
6800 WEST LAKE ST.
ST. LOUIS PARK, MN 55426- MAIL-IN FEE 2.00
(612)702-6622 TOTAL 52.46
PAID WITH CC# 3833
OWNER
MCLEAN,CHRISTOPHER& ELIZABETH
l 14 CHEVY CHASE DR
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this pcnnit 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 requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whe[her or not specitied herein.This 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 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 time for due cause.
� �YI 11.C-�.C�) lP i o�C�i/� C�'✓j/l,l(.YL �i a�j 8'i /oZ.,
Applicant Permrtee S�gnature Date Issue y Signature Date
SEPARATE PERMITS REQIJIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
6E128f2fl12 11:03 9529222434 SAVLER HVAC PAGE 02/04
' FOR USE ONLY.
0 City of Orono �j /�
0� �� P,O.Box 66 ':Dare Recxiv¢d' YPermic�' � D�/I �
2750 Kelley Park�vay �
� ,� Cry5ta18uY.MN 55323 ':Pl,pproveday-... ' A,�ouAtS:. �
Phone(952)249-4600 Fex(952)249�616
CZ�'X OF Oki3O,NO—MECHA,NIC,Ax,Y�R1ViYT
(All Commercial pertnits must be approved by the Huilding OffiCi21 or InSpeCtor and/ot'Flfe Me(Shall)
GEi�i��n.v:�o�T�orr . � .
l. You may apply for mcchanical pormits by mail or in person at the City offtces. A�plications wi11
be reviewed and a�ermit will be issued within two working days. �
2. Permit cards will be sent by�etum l7xail aRet a review is cortapleted. ���'�'S A,RB NO'�'
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD iS POSTED ON THE JOB S1TE. •
3. Mcchanicat Dcsiens—Complcte calculations,details and specifications arc rcquircd for cach
h�ating,ventilation,humidification-dohumidification,and air conditioning installation including
heat loss/heat gain calculatioza,desig�n tenoperatu�es,equipment ratings apd'ldenti�cation,as to
typc,manufacturcr and modcl. Data shall bc prescntcd on form providcd.
4. When any new construction or remodeling is involved,a separate building permit muse be
obtained.
5. All work must be done in accordance with the Uniform Mechanical Code/Scace�uilding Code
rec�uirements•
6. All work must be inspected(rough-in and final). Call(952)249-4600.
(24-48 bour notice requlred)
7. House Heating Test Record must ba submitted before final.
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,:.�:: �: � : : :` TYPE::OF.PE�MZT.
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�;,Residential ❑Commercial(Approval Required)
❑New �Qddit�ona� ❑�tepai�s ❑Replace
'�7ob:Sxte/'Oaa�e�'��r��.o�atios�: .
Site Address: ��� G��U��/ C_.1-!P9-SE. ��,
Ow�er: C►�+�t�S ML�.�i4,.., Mailing Address: S�ov��
City: wtav �TA Zi�: S�3�i t
Hot�n.e �k�one: Alternate Phone:
. ... .... . ...........
Co�a�r�acto�Infornlation:: ;.::;. ,.
Contractor: ��V�+� ��'Ttv�o Contact Person: �Nl4�� '�A1�L.C�
� Address: �YJ� ����' ��5�� State Bond #:
' Cxty: �� Zip;��xpiration Date:
Phone: ��a-���`6�� Alternate Phone:
❑ ��sux�ce—CurreT�t:
]
06/28l2�12 11: 03 9529222434 SAVLER HVAC PAGE 03/04
Note: A,1] Geothermal Systems will now requ,ire a Site Plan 8c Review by our Building Official.
IS THIS GEOTHERMAL7 ❑Yes �No
HEA'��NG SXS'�EMS � `
Quant�ry:
Make:
Model:
k'uel:
Flue Size:
]nput BTUs:
Output B�'Us:
CFM:
COOLING SYS'�EMS
Qua�tity:
Make:
Model:
�'ons:
H.Power
k`IREP�ACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Firepiace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kttchen Exhaust duct recirculating cfim
❑ No. �atk��xbaust(anust have ducc outside) c�
❑ No. Othcr Fans: Locations cfrn
FUEL STORA,G� (.Must be a.pp�oved by Fire Marsha!!cf propasing to ubandon tank in pJac�)
❑ Installation ❑ Removal
�uel Oal: gallons ❑ Underground ❑inside ❑Outside
LP Gas: ga��ons
Other:
GAS LINE ONLY
❑ Outdoor Grill � Other/�,ist Wk�at&Wk�ete: ��lZh��KrC
2
06/28/2612 11:93 9529222434 SAVLER HVAC PAGE 04/04
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❑ Yes,this section applies
Thc rcplaccment of a e 'de tial fixtarc or ' ce that meets al I three o�the following requi�cements:
�. Does noc require modification to electrical or gas service.
2. Has a t 1 c st of$500.00 or less;e c ud'n the cosc of che�jxture or appliance:and
3. Is i�mproved,installed or teplaced by the homeow+�er or licensed contractor.
Skip n,ext section,if tk�is appl�es; Cost o�Permit $ 15.00
State Surchafge $ s_oo
Mail-!n Fee(1�.A,pplicable) $ 2.00
Total�ernait�ee $
If above does not apply;follow gvidelines below:
1. CONTRACT PR10E *is �25%af contract price with a(Mlnlmum k'ee of$50.00)
ti?A�Oc7 �_Oa25$ ��OU
(Contcact price) (minimum$50.00)
2. STATE SURCHARGE
�iLa=ot� X.000s $ •ti�
(contract price)
3. POSTAGE&HAND�.ING(Only on Meil-�n Applications) $ Z.00
4. TOTAL R�KMIT FEE(Add Lines]-3 Abave) $ SZ•`��
■ * CONTRACf PRICE ox JOB COST areans the actual or esti�mated dollar amou�t charged for the
pernutted woirlc in�c�udi�ng matorials,labor,profit,and othe��xed costs. It is tk�e amount to be charged
to the custotner for th�e work done. If any material, equi�ment, labor or installations are furnished by
the owner,tenant or any other patty,the reasonable nnarket value of such ite�ns must be added to the
estinnated cost or contract p�ice for permic fee purposes. In the event that there is a dispute on the
amount of the job cost,the City may z'equest the submission. of a signed copy of the actual eontract.
The undersigned hereby app�ies to the City for issuance of a Mechanical Permit, agrees to do all
work iz� striet accordance with the ordinances of the City and the regulations v�t�;e State of
�i�zu�esota, and ce�ti�es that all staterx�e�nts made on t�.is applieation are co�nnplete, true and
conrect.
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Applica�.t's Signature: l" pate:�2'Z '��''►L _
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„���, ' ay_���� .,�:::�a�s�.:
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L� � <� �TE TIME V
CITY OF ORONO — GALLED IN �'✓ �� �
INSPECTION NOTICE SCHEDULED � C ��
PERMIT NO �=OO I COMPLETED %' ��
ADDRESS �
OWNER TEL HONE NO.����
CONTRACTOR
�: DESCRIPTION`� �'�
�
� ❑ FOOTING ❑ PLUMBING FIN L ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
� ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNERlFIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
J ❑ 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:
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WOR CTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑CORRECT WORK 8�PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hour ' a nce. (952� 249-4600
OwnerlContractor o site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice