HomeMy WebLinkAbout2008-00274 - heating system � `' CITY OF ORONO PERMIT NO.: 2oos-oo2�4
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 10/06/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 1]79 ELMWOOD AVE
PIN : 07-117-23-14-0030
LEGAL DESC : SKARP&LINDQUISTS FERNHILL LA
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 4,100.00
NOTE:
REPLACE HEATING SYSTEM-TRANE 95%,TUC060,NATURAL GAS,3"PVC
6Q000 INPUT BTU'S,57,000 OU`I'PUT BTU'S
APPLICANT MECHANICAL 51.25
RAY N. WELTER HEATING CO STATE SURCHARGE MECH(VALUATION) 2.05
4637 CHICAGO AVE TOTAL 53.30
MINNEAPOLIS,MN 55407-
(612)825-6867
OWNER
GARLOCK, MR. &MRS. BRUCE
]179 ELMWOOD AVE
MOLJND, MN 55364
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according[o
the approved plans and specifications,applicable City approvals,and [he
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 180 days of the date of issuance,or if consVuction 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 S[ate Quilding Code,This permit may be
revoked at any time for due cause.
, � � � lD /C��J l ��
ApplicanY Permitee Signatur Date Iss d By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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FOIt CI` 1'USG ONI,I'
O¢��Q`A"�� City of Orono l �/�5� (�
`ro`� P.O.Qox 66 Date Reccivedh � Permit ll l�V�"!/' ��j
�� �� . 2750 Kelle��Park���ay ���j
4�1� ;i`�?>,;:. �� Crystal 13ay,MN 55323 Approved I3y: Amount$:`5�-�-0
��,�`!;j;!�„�`G (952)249-4G00
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CITY OF ORONO-MECHANICAL P�RMIT
(All Commercial pennits must be approved by ihe Building Official or]nspector and/or Pire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical pem�its by mail or in person at the City offices. Applications will
be reviewed and a permit will be issued wiihin two working days.
2. Pennit cards will be sent by return mai) after a review is completed. P�RMITS ARE NOT
VALID UNTIL YOU R�CE]VE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTGD ON THE JOB SITE.
3. Mechanical Desi�ns—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air conditioning installation including
heat loss/heai gain calculation,design temperatures,equipment ratings and identification as to
type,manufacturer and model. Data shall be presented on fonn provided.
4. When any new construction or remodeling is involved,a separate building pennit must be
obtained.
5. All work rnust be done in accordance witl�the Uniform Mecl�anical Code/State Building Code
requirements.
6. All work must be inspected (rough-in ai�d final). Call(952)249-4600.
(24-481iour notice required) �
7. House Heating Test Record must be submitted before final.
TYPE OF�ERMIT
(Check All That Apply)
� Residential ❑Commercial(Approval Required)
❑New ❑Additional ❑Repairs eplace
Job Site/Owner Information:
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Site Address: l 7 ��YJ��..�C%G�� �� ' ��-! �,
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Ow�1er: �� -�/�{`��,(�'' MailingAddress: � � 7 / [-',��'��UC���;;���
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City: C��� � �I�% Zip: _`������_
Home Phone: ��:�- G/I,�- .�f�� Alternate Phone:
Contractor Infonnation:
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Contractor: lf v �, '� �-`� �l ��L� Contact Person: , I' �
Address: ` � �� '�1 - :� /L�; State Bond #: `7 �G�bC�� /[�
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City: �� ���, _ Zip:)� �,��x�piration Date: L�G, ��� � �C���%�
Phone: �j����• ��1,� '���C�� Alternate Phone:
❑ Insurance-Current: c'�'L � ��� �ti��%CDS��J
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MECHANICAL SYSTEMS BEING INSTALLED
HEATING SYSTEMS
Quantity: '
Make: � !a � ��
Moae�: � �9(: E-�
Fuel:
Flue Size:
'' )C
Input BTUs: •� G'`'l.`
Output BTUs: ��, ��
CFM: �
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
❑ Gas Factory Fireplace
❑ Wood Burning Fireplace
❑ Wood Stove
❑ Wood Stove With Flue
Brand Name: Model No.:
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL)
❑ lnstallation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑lnside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
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�� PBRMIT FEE CALC[�LATION(S) �
QASCD OFF — 2002 STATE STATUF,
❑ 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; excluding 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-[n Fee(If Applicable) $ 1.50
Total Permit Fee $
�;,��,;�: PERMIT FEE CALCULATIC)N(S)—JOBS OVER $500.00 �
If above does not apply; follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00)
r �_
�L7t� �� X.0125 $ ��, ��
contract price) (minimum$35.00)
2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
� t��.
L� �;`L` � x.0005 $ �
contract price) (minimum$ .50)
3. POSTAGE&HANDL[NG(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �/���
■ * 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 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.
; �n MECHANICAL PERMIT APPLICATIt�N ACrREEMENT
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.
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Applicant's Signatuce:�-"°"'��� - /��' Date: ��'1 ���
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