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Home My WebLink About2004-P07520 - gas line inspection CITY OF ORONO PERMIT 27�0 Kelley Parkway - PO Box 66 Permit Number: Po�s2o Crystal Bay, Minnesota 55323 Permit Type: Me�hani�al Pe�cs (952) 249-4600 Date Issued: si2i�2oo4 SITE ADDRESS: 770 Dickey Lake Dr I.ong Lake,MN 55356 PID: 27-118-23-33-0010 DESCRIPTION: Proposed Use: Residential Permit Class: General Permit Type: Mechanical Permits Permit Sub-type(s): Gas Line Inspection DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 15.00 Valuation: $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 15.50 APPLICANT: Practical Systems OWNER: Charles&Jill Leukuma 4342B Shady Oak Rd. 770 Dickey Lake Dr Hopkins,MN 55343 Long Lake MN 55356 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. i � � i�L ' L i � / � �Cc 6'� �(,�f'�J ' APPL CANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Cooies: 1-File(SiQnitures Required), 1-Avplicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 ! � CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT 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 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 BEG1N 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 form provided. Identification of and specifications for water heating equipment shall also be provided. 4. When any new construction or remodeling is involved, a separate building pernut 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-hour notice required. 7. House Heating Test Record must be submitted before final. Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call (952) 249-4600. Please check one: ❑ New ❑ Addition ❑ Repair ❑ Replace�Residential ❑ Commercial '7 7� �i C,,�7/ .l�,�2 ;I�r,v� JOB SITE: � � iC _ Zip: Owner's Na e: Phone Number: Mailing Address: City: Zip: Contractor's Name: ��i c � � �rS Phone Numbe� Cl�l �cJ'�3- /��' � Mailing Address: �/3y2%� S �iaa/S/04/< ��,/. City: �fJ�:_� S Zip: SS 3 z �'f 1 � , SYSTEM DESCRIPTION HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: Input BT'LJs: Output BTUs: CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: H.Power FIREPLACES GAS LINE ONLY ❑ Gas factory fireplace `�Installing a Gas Line Only ❑ Wood burning factory fireplace with flue ❑ Wood Stove ❑ Wood stove with flue Brand Name Model No. VENTILATION No. Kitchen Exhaust duct recalculating cfm No. Bath Exhaust(must have duct outside) cfm No. Other Fans: Locations cfm FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) ❑ Installation or ❑ Removal ❑ Fuel oil: gallons ❑ underground ❑ inside ❑outside ❑ LP Gas: gallons ❑ Other Gas opening 2 � i PERMIT FEE CALCULATION(S) 2002 State Statute es This Section Applies The replacement of a Residential fixture or appliance that meets all 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; excluding the cost of the fixture or appliance: and 3) Is improved, installed or replaced by the homeowner or licensed contractor. Skip next section; Cost of Permit $ 15.00 State Surcharge $ .50 Mail-In Fee $ 1.50 If above does not apply, follow guidelines below: 1. Contract Price* is .0125%of job with a Minimum Fe of $35.00 � � 3�� " X .oi2s $ 3S� (contract price) (minimum$35.00) 2. State Surcharge. ** Add the State Building Code Division a Minimu F of $ .50 x .00 .S'c7 (contract price) (minimum$.50) 3. Postage and Handlin� (Only mail-i�: applications) $ 1.50 . A�y u/ 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 3� *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 material, equipment,labor,or installation is 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. **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 Inspec[ional Services for the price. 'fhe 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: �L�` .�� Date: 5/��5w Approved By: Date: 3 1 �' J � �ATE TIME � . �F ORONO iN /�/�y INSPECTION NOTICE SCHEDULED 5/Z�/�� .� PERMIT NO. /�U`�� COMP�ETED - ADDRESS � 7 U F�i C !!s �-� C- /L /��Z OWNER CONTR. P��'+ S��S . TELEPHONE NO. �I-`�� - �� 1 �Co � � DESCRIPTION u`-�� J � �!''�-� - f�11� l�.-�-�- � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES�NO � COMMENTS: � W � � J O >- � O � W � Q � Z W � W � j d W WORK SATISFACTORY:PROCEED f_; PROJECT COM"' � ❑CORRECT WORK&PROCEED r: ISS�� W O G CI�RRECT WORK,CALL FOR REINSPECTION V BEFORE COVERING ❑ CORRECT UNSAFE CONDITION WITHI�� INSPECTOR WILL RETURN ❑STOP ORDER POSTE� " ❑ INSPECTI(�"'"