HomeMy WebLinkAbout2016-00784 - gas line only , CITY OF ORONO * Z 0 1 6 - 0 0 7 8 4 *
2750 KELLEY PARKWAY DATE ISSUED: 07/07/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4700 CREEKWOOD TR
P[N : 30-118-23-33-0004
LEGAL DESC : PAINTERS WOODS
: LOT 002 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : GAS LINE ONLY
VALUATION : $ 350.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
GASLINE FOR STOVE
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 0.18
WELD& SONS PLUMBING CO INC. MAIL-IN FEE 2.00
3410 KILMER LANE N
PLYMOUTH,MN 55441- TOTAL 52.18
(763)475-0296 Payment(s)
Minnesota State License#:plbg-PC646375,mech-MB003315 CREDIT CARD 6763 52.18
OWNER
ERB,JEFFREY&TRACY
4700 CREEKWOOD TR
MAPLE PLAIN, MN 55359-
AGREEMENT AND SWORN STATEMENT
The work for which this permit 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 whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within I80 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time afrer 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�ause.
�
-Pl �i 7 i /(o
Applicant Permitee Signature Date Issued B S nature Date
4 cx7C U5E OrT�X
� O City of Orqp�q /�
� � P.O,BaY 66 Date Rece,iv���. � e,�it# ���. `�`� ���
Q 2 �
750�etley�arkway
Cry�ni�ay,MN 55323 Approved BY� , A�ourrt$:-s� .
�hone(9S2)249-4600 Fax(952)249�e16
���� �G� CITY Q�'QRO
��sxo� NO—MEC�Ai'vICA�PERN��T
(Af1 Commercial pce�its must be a��p�n�red by tbe suilding Qf3ic�s1 or Inspcccor snd/or Fire Marekza]))
GENERAL�VFORM�'Z'ZON _
1_ Xou may ap�iy for mec�arzical permzts by mail or azz�eer5on at dxe CiCy o#�ces. Applicatio�as will
bc revie�ved anc�a�e�nir.t�iIl be isstied wit�i�z ttvo ��rkEiag d.ays.
2. Perntit cards will be se��t by ret�un zraai��FCer a review is con�p�eted. PERM�'�S 1L�tE NO"�
V,q,I.�D�JiVTIL YOU�CEZVE A PERl���', V'VORK. �JST NOT F,CrIN UNT '�'$�
P�RM�T CARb�S�QSTEb 0�1 THE JQ�SITE
3. Mec�a ical Desi ns^Co�rzplete ealcu�ataons,details and speci�ications are re�ua��ed.for each
beatang,ventilat�on,humidi�catzon-de�iu�di�cation,ar�d air conditiouaqg installatioz�including
heat lass/k►eat gain ca(cnaation,d�sig�temperatu�-es,equipment xatangs and identi�cation as to
type,manu£act�•er and modea. I7a2a shalI be�resented on form provided,
4. Whe�,any new coz�stzuction oz r�naodeling is izavalved, a separaie building�ez�nit must be
obtained.
5. Ali work must be done in accoxdance witla tbe Uniform Mtechanieal Code/State Bua�d�ng Code
requz��ernents,
6. ,A,ll��ork z�aust be inspocted(rough-in and��al). Call(952)249-460Q.
(24-48 hour not�ce z�ec�aired)
7. House H�at�Test Rccox-d zirxust be subrz�atted before�uaaJ,
TYPE OF`PERM�T ..
Ch�c�C.A.�l T'hat A �
(�Residential ❑Cotrunc�cxal(A�proval Required) [Bac�ow Llevice_�,A,VB �PVB)
❑ New ❑Ad.ciilional ❑Re�airs ❑Replace
Job Site'/:Owner infor�zxat�on:
Site Address: Y��� ���'"r...>O o� Tt`c,_,,'
4wner:�G Y �r"b MaiZxz�.g Address: �7da ���ex�oe` Ti�;/
Cxty: O +�c9 r�c� Zi�: ��.�� �J
�-Tome Phoxze: ��Z� �'3 /�4� Alterz�ate T'hone:
Contractor I�r�formatio�:. "
ConEractoz: _�Pif�. f- �p�,� /���,�.f�,`,��oz�tact Perso�,: ��,�
Add�•ess: 3y/O k;f„u�r �,�,�,U �tate Bond#: _�9�pCj 3 3/S`
City: �+�toJTh Z�p:�Sry�/E�pu-ation Date: _ ��2� --l(�
Fl�a��e: �6 3 '���CaZ�j� ,AlternaCe �laone:
❑ Ir�sux�ce^Cttrre�t: ��`d,�,/t 1� ��,�
X
l�'ote:All Gep�zermal Systems wil�now rec�uire a Site�1an&Review by our Buildxzzg Official,
�S THIS Gk:OTHER.;I�AL? ❑Yes ❑No
FI�A,Ti�iG SYS�'EMS
Quai�#jty;
Make:
Mod�1=
Fuz�;
Flue Size:
Input�T[1s:
Out�u.t BTUs:
c�ti�:
COOLING SXSTEMS
Qnannry:
Make:
11�ode1:
To�as:
H.Power
�TRE�T,,ACES
❑ Gas�'actory FirepIace Bzaz�d Name:
❑ Waod Burnirzg k'ireplacc
❑ �ood Stove 1�ode1 No.:
❑ Wood Stove with Flue/Masonry
'�ENT�,ATION
❑ 1Vo• Kitcbe��xhat�st duct recixcu�atang cfm
❑ No. Bath E�aust(must l7ave duct ou�side) ���
❑ No. QEhez•Fans: Locations cfm
iTEL STO GE (A7usr be approved by,F'ire ll�larshall if propnsing ro arbanr�on tank in,plac�)
❑ Ynstallatio�a ❑ Removal
k�et Oil: ��allo��s ❑ Undergrouad j]Inside ❑Outside
Lp Gas: gaIlons
Ot.�er:
GAS LL1�pN�,Y � ����� �/Cl �I��.��
❑ Outdoo�Gz�zll � OtL�er/Lxst W;�at&'SNtiere:, G�.,S �r�i ��—�TD 1/2��
2
�. CO T�t 4CT P�t�C� * �s �.25%o�contraot pr�ce with a(��inimum k'ee of�50.00)
�_;p , c7 p �.oYzs� d . C)D
{cont��act price) (minimum 550.00)
2. S"t'. 'Z'�SLTRCI�A�,�tGE
� ' 0� x.0005 � ,
(coczhact pi7ce)
3. POS�'AGE&HANbLING(Only oa�Mail-In Ap�lication,$) $_ 2.00
4. TQ'�.A„L PERNI,�'�'k'E�(Add Lines Z-3 l�bo�e) � ,��, � �
• * CONT�t,A,CT YRIC� or J'OB COST means the actual or estimated dollar amount ck�az�ged for tiae
pernaitted wor�C az�cluding�xzaterials,�abor,pro�t, aad other fzxed costs. It is the azx�ount to be charged
to the customer foK t�e work do�e. I�any zx�;aterial,equi�merit,labor or instaIlations are�'urnished by the
owrier, �enant ar ariy othex party, tl�e reasonable market value of such items znust be added. to the
estimated cost or contraet price for pem�it�ee p�uposes. In the eve�nt t��at thexe is a,dis�ute on the a�otu�t
o�' the job cost, the City rttay x-equest t.�,e submission of a sag�ned eopy of the actual eo��,tract.
T�Ze u,ndersig�aed hereby applies to the City for issuance of a�techanica� Permit, agrees ta do aIl
work in st�eict accoXdance wzt� the oi�iataances of the City and the xegulatioz�s of the State of
MiiuleSOta,and cex-ti�es that a11 st��terne;�Cs made oz�this a�p�ication ar�com;plet�,true ar�d correct.
Ap�lacaut's 5ag�zature: �eL� ����Trv�--�' �7ate: 7 -` �'��
3
�� � ] `
��'� DATF�` TIME
CITY OF ORONO ���CALLED IN
INSPECTION NOT�CE �U�' SCHEDULED � / lr. �-,-.
PERMIT NO. ,�,� � coMP�erE�
ADDRESS L-�� �I l:C� (� �"�-� IL i,1�0� �2'
OWNER TELEPHONE NO. �7 �`'3'"�I�5�'OZ9�
CONTRACTOR �ov� �i �S
� DESCRIPTION �������T,(�`'j�S � I ��r
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING �
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION �
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS, .
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT �`��(��`e�
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ E TIC INSTALL
2 OWNERlCONTRACTOR TO MEEi YOU: YES_NO
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� COMMENTS: ��rl S �Ci�
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W ❑WORKSATISFACTORY:PROCEED PROJECT COMPLETE
� ❑CORRECT WOflK 8 PROCEED ❑IS E CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WlLL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 ho rs in adva 49-460�
OwnerlContractor on site: %
Inspector.
i
White Copyllnspector's Ffle � Canary Copyl�te Notice