HomeMy WebLinkAbout1993-004934 - mechanical� .�
PERMIT �
�.,IT.� OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 Permit Number: �'�"t��������`��"'
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�rystal Bay, Minnesota 55323 Date Issued: - -
(612) 473-7357 f''='''�'�':�`=�:=:
SITE ADDRESS:
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APPUCANUPERMITEE SIGNATURE ISS D 9Y SIGNATURE
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CITY OF ORONO
APPLICATION FOR MECHANICAL PERMIT
GENERAL INFORM�TION
l. You may apply for mechanical permits by maii or in person at the City
offices. Mailed-in permits are subject to the postage and handling fees
shown be3ow.
2. Permit cards will be sent by return mail the same day the application is
received. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT
BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE. ,JOB. SITE.
3. When any new construction or remodeling is involved, a separate building
permit must be obtained.
4 . All work must be done in accordance with State Building Code requirements.
5. Al l work must be inspected (rough-in and final). CaI I 473-7357. 24-hour
notice required.
6. House Heating Test Record must be submitted before final.
INSTRDCTIONS Complete all items on this application. Compute the permit fee.
Sign and date the certification. 1NCOA%1rL�TE A�PLTCA•i�i�IvS WILL 'cJO�T B�, �ROCES�E�.
If you have questions, cal 1 473-7357.
WALK-IN PERMITS apply at City Offices, 1335 South Brown Road (Cty. Rd 146)
MAIL-IN PERMITS enclose fee - Mail to: P.O. Box 66, Crystal Bay, MN 55323
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Please check one: New Addition Repair x Replace
JOB SITE: � .7 � 5 p /���ur � /� �: . Zip:
Owner' s Name: S,v��-� 2��0.� Telephone Number:
Mailing Addr�ss: > �ity: Zi�:
1t�t��7 n�r������..�
Contractor' s Name: azcoco�tiaM;r��. Telephone Number:
Mailing Address 5�«���PaR'�.'�'�' ` _= City: Zip:
*********************� � ��r� ********************************************
MINIMUM FEE ( $30. 00 per project)
********************************************************************************
SYSTEM DESCRIPTION: $15. 00 each unit
Heating Systems : �
Quantity:
Make: f} �
Model. (3- l� Q� b Y3 3 �
r^ue3. ,o�-o�-� q�
Flue Size. �
Input BTUs : c �� ,
Output BTUs :
CFM:
********************************************************************************
Cooling Systems:
Quantity:
Make:
Model:
Tons:
H.Power. � '���
********************************************************************************
.
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*WOOD BIIRNING EQIIIPMSNT $15.00 each unit
Wood stove with flue
Wood combination or add-on unit
Factory fireplace with flue
Factor Fireplace (s) freestanding Masonry
Wood Stove (s ) franklin, other
Brand Name Mode 1 No.
Mfgr' s Min. , Clearances, side , rear , min. flue dia.
Total
************************�****�*************************************************
VENTILATION $15. 00 each project
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. Other Fans: Locations cfm
Total
*******************************************************************************,
FIIEL STORAGE (must be approved by fire marshal )
� $30. 00 Permanent/Temporary
Fuel oil, gallons underground inside outside
LP Gas, gallons
Other Gas opening
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GAS LINE INSPECTION
High/Low Pressure $15. 00
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PERMIT FEE CALCOLATION
1. Total of above Installations or Minimum Fee ($30.00) $ �j0 • �O
2 . State Surcharge. Add the State Building Code Division
Surcharge to each permit $ . 50
3 . Postage and Handling on all mailed-in applications, $ 1. 50
4 . TOTAL PERMIT FEE add lines 1-3 above $ ��_ � �>
The undersigned hereby applies to the City of 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.
� � �� 1 �'
Applicant' s Signature: � � �� ��-_Q. Date: �` �` �3
� .� ,.
- ' ��` �� ��� � 4
DATE TESTED�_��_°i.� HEATING TEST RECORD �og rvo.___g 7`�
ADDRESS __.c�.���7�'���.L�_�Q�c�_�/ _�_ __ CITY __�C'`.i�_LJ�__
/ (' .
OCCUPANT _ .J_�___L�_A�_ �
- --------
___.__- OWNER
SOLD BY _ _ __ ___ INSTALLED BY ��}��____1.i�I`�+'T� "Lv
-- _-- --- - -
__ —_ _-._ ___-
MAKE_ �_�_��J_�___ _ ___ MODEL ��3�_y2_=.V ���
� �LQ����Q � � -- --- INPUT _ �03��
SERIAL NO. __ _ _ _
THERMOSTAT _ A� � �)
-T�C�t�-_- __-_- VENT SIZE__s�____
VALVE _���'j� _ _ ______ ___ __ __ TYPE OF LINER__� Y�_—_
LIMIT_�cci'�C-��-�_�_ LIMIT SETTING __��� _ - LINER SIZE _ r� ��__ ._-__ _-___ _ . _-
FAN SETTING __��-1CY�_�_� ___ ___ _ ____ _ __ FILTER SIZE�.�p,�L�.�1�_I_NUMBER __ _ ___ _ ____ __-____
� . � �y � r
PILOTTYPE�C'_� __��.�.i�-l-��-�-- -- _ WIRING __ � ___--- -- _ ____._
IGNITION MODEL__-- _ TESTTAG _ �i___ _
PILOT TIMING LIGHTING INST.4...___ _
-- _ -- ---- - - - -_ --- _ - -- -- - _ ___ --_ _ _ - -
PRESSURE___ ���1) __ __ _ INPUT CFH _ __.��t _ _ ___ _ __ STACK TEMP. �� �O_
PERCENT COZ____ _ PERCENT OZ _-.���.1_._ -__. ___ PERCENT CO Q� 2"f
—• /.� „ •
COMPANY TESTING �l_�r � �I _�__._.___,_ NAME OF TESTER __�1_�1�
FORM 235(REV.11/92)