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Home My WebLink About2009-00825 - mechanical CITY OF ORONO PERMIT NO.: 2009-00825 , 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUEn: 1U17/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 965 EDGEWOOD HILLS RD PIN : 02-117-23-14-OOOI LEGAL DESC : REG. LAND SURVEY NO. ]098 : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : MECHAN[CAL-MULTIPLE VALUATION : $ 5,800.00 NOTE: HEATING SYSTEM-(1)LENNOX-MODEL: G43UF-36B-45-NATURAL GAS-2" FLUF, 45,000 INPUT BTU'S,41,400 OUTPUT BTU'S-800 CFM COOLING SYSTEM-(1)LENNOX-MODEL: 13ACX-Ol8- 1-1/2 TONS (2)BATH EXHAUST AND(1)CLO"I'f iES DRYER FAN APPLICAI�TT MECHANICAL 72.50 SELECT MECHANICAL SERVICES INC. STATE SURCHARGE MECH(VALUATION) 2.90 6219 CAMBRIDGE ST ST. LOUIS PARK,MN 55416- TOTAL 75.40 (952)926-4488 OWNER CUSICK, MR. & MRS. THOMAS 965 EDGEWOOD HILLS RD WAYZATA,MN 55391 AGREEMENT AND SWORN STATEMENT The wark for which this permit is issued shall be performcd 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 no[grant permission for additional or rela[ed work which requires separate permits. All provisions of laws and ordinances goveming 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 l80 days of the date of issuance,or if construction is suspended for a period of 180 days at any time atter work has commenced. The applic t is responsible for assuring all required inspections are requrte�ted conf anc�with th at [3uilding Code.This permit may be rev,6l:�d t ny�or ue cau . � �v � �� - 11 � �7 � o� , ,� Applicant Per itee Signature Date Iss d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � � R� FO CITY SE ONLY , ,�'0"�:\ City of Orono /�� /��— ��$ � � � �� P.O.Box 66 Date Received: � �rmit# oC ''� ��''�� 2750 Kelley Parkway � ;\\� n�'�. ,�,�I Crystal Bay,MN 55323 Approved By: Amount$: 7 �� ''' ' �,�o`;�� (952)249-4600 �� CITY OF ORONO—MECHANICAL PERMIT (All Commercial pennits must be approved by the Building Ofticial or Inspector and/or Fire Marshall) GENERAL INFORMATION l. You may apply for mechanical permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desiens—Complete calculations,details and specifications are required for each heating,ventilation,humidification-dehumidification,and air conditioning installation including heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to type,manufacturer and model. Data shall be presented on form provided. 4. When any new construction or remodeling is involved,a separate building permit must be obtained. 5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code requirements. 6. All work must be inspected(rough-in and final). Call(952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before final. TYPE OF PERMIT Check All That A l Residential �Commercial(Approval Required) ❑ New (�Additional ❑ Repairs ❑ Replace Job Site /Owner Information: Site Address: I � � �OG��6d 0 �\L-� I`DA� Owner: Cu S<<-� Mailing Address: City: �� Zip: SS-3`�f Home Phone: Alternate Phone: Contractor Information: Contractor: SELC LY ��'��L'Contact Person: �� AU��'�� Address: �OZ�� AMgRI��+� �2g�State Bond #: City: S?.�.dt�'� P�� Zip: SSy1 G Expiration Date: Phone: �S Z'�Z�" �`��$ Alternate Phone: gs2"`f S2= �/SZ S ❑ Insurance—Current: 1 , � � MECHANICAL SYSTEMS BEING INSTALLED Note: All Geothermal Systems will now re ire a Site Plan& Review by our Building Official. IS THIS GEOTHERMAL? ❑ Yes �No HEATING SYSTEMS Quantiry: / Make: ��JJ N VX Model: Ct�{3U1 -368-'ts Fuel: �^��-� Flue Size: Zu Input BTUs: � � Output BTUs: �V CFM: S�D COOLING SYSTEMS Quantity: I Make: L��^�d� Model: ��jALX-��$ i Tons: Z H. Power FIREP ACES ❑ Gas Factory Fireplace Brand Name: ❑ Wood Burning Fireplace � Wood Stove Model No.: ❑ Wood Stove With Flue VENTILATION ❑/ No. Kitchen Exhaust duct recirculating cfm [� No. 2 Bath Exhaust(must have duct outside) l�O cfin � No. � Other Fans: Locations �I.�TN L�S D(L`/!�(L i 3 S cfm FUEL ORAGE (Must be approved by Fire Marshall iJproposing to abandon tank in p[ace.) � Installation � Removal Fuel Oil: gallons ❑ Underground � Inside �Outside LP Gas: gallons Other: GAS L ONLY ❑ Outdoor Grill � Other/List What&Where: 2 : - ti PERMIT FEE CALCULATION(S) BASED OFF -2002 STATE STATUE ❑ Yes,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;excludinQ 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 $ .50 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ PERMIT FEE CALCULATION S -JOBS OVER$500.00 [f above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) s� �� x .0125 $ �Z.. sd (contract price) (minimum$50.00) 2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50) S Q O� x.0005 $ Z• I � (contract price) (minimum$ .50) 3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ��• �U ■ * 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. [t is the amount to be charged to the customer for the work done. If any material, equipment, labor or installations are 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 Building Department at(952)249-4600 for the price. 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: Date: �� / Reset Form 3 � �� AT TIME CITY OF ORONO ' CALLED IN /z � D INSPECTION NO I E DULED / O � PERMIT NO. � �g��PLETED . ADDRESS / -� � �� OWNER CDNTR. �l.�C�i'l�t��- TELEPHONE NO. ' ��a`�a 'g(o7�"�'� � DESCRIPTION v � ��-l/� ��'`�v � ❑ FOOTING �iMECHANICAL RI ❑ EXCAV/GRADING/F�LLING ,Q ❑ FRAMING �❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C o `�.� � tT-j�� '�-% �' `f-- � � � -��.�lg ....... :�S _S•-� /-� �-f-,' �.�,; Q j� v /� �-j-- � v z W � W � � d � ,�HK SATISFACTORY:PROCEED f7 PROJECT COMPLETE W ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP OFDER POSTED.CALL INSPECTOR !' CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Cail for the next inspection 24 hours in advance. �952� 249-46QQ Owner/Contractor on site: ' Inspector. White Copy/lnspector's File Canary Copy/Site Notice S� e�`�1 DA TIME Y CITY OF ORONO ,J'CALLED IN �d INSPECTION NOTICE J�JQa� SCHEDULED /U a..o-� PERMIT NO. � u/Uv�' COMPLETED ADDRESS /C� OWNER TELEPHONE NO� — �� CONTRACTOR � ' � DESCRIPTION ��1 � ��-L�(f! � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS y ❑ FRAMING '�MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION /❑WOOD BURNER/FIREPLACE ❑ 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 ❑ PLUM ❑ SE TI FINAL ❑ FOUNDATION/REMOVAL � O R/CONTRAC MEET Y . YES_NO � CO NTS: � W � � � O � � O � W � Q � 2 W � W � � d � ❑WORK SATISFACTORY:PROCEED ROJECT COMPLETE W ❑CORRECT WORK R PROCEED �E CERTIFICATE OF OCCUPANCY � 0 CORRECT WORK,CA�L FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. u PHOTOTAKEN INSPECTOR W4LL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. �952� Z49-46QQ OwnerlContractor on site: Inspector. a White Copyllnspector's File Canary CopylSite Notice.