HomeMy WebLinkAbout2016-00862 - mechanical `� � CITY OF ORONO * Z 0 1 6 — fd 0 8 6 Z *
2750 KELLEY PARKWAY DATE ISSUED: 07/2U2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2648 CASCO POINT RD
pI� : 20-117-23-24-0039
LEGAL DESC : WINSH[PS SUBD LOT 1 SPRING PK
: LOT 000 BLOCK 003
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENT[AL
CONSTRUCTIOi�i TYPE : COOLING SYSTEMS
VALUATIOPI : $ 4,820.00
NOTE: REPLACE A/C
APPLICANT MECHANICAL 60.25
STATE SURCHARGE MECH(VALUATION) 2.41
SEDGWICK HEATING&A/C MAIL-IN FEE 2.00
1408 NORTHLAND DR-SUITE 310 .
MENDOTA HEIGHTS,MN 55118- TOTAL 64.66
(952)881-9000 Payment(s)
CHECK 16844 64.66
OWNER
ESSEN,JEFFREY&BARBARA
2648 CASCO PT RD
WAYZATA,MN 55391-
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 1 SO days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The appiicant 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 cause.
' �e�G� 7 / �� l /:(o
Applicant Permitee Signature Date Issued Signature Date
1--��-Z°l l i l��, l.� (�
OR TY USE ONLY
�'� � City of Orono � �
, - � / ���� P.O.Box G6 _ � Date Recei4�d� �� Permit#���� ��
/ � � 2750 Kell�y Parkway �
Cp�stal Bay,MN 55323 , Approved By: Amount$:�
� � Phone(95?���9=�i0b ��52)249-4616
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`� �.� .��'��ORONO—MECHANICAL PERMIT
\�FS f�pl'-
, (All Co��crc�al permits must bc approvcd by thc Building Ofticial or Inspcctor and/or Firc Marshall)
�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
VALIU UNT1L YOU RECEIVE A PERMIT. WORK MUST NOT BEG1N UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Designs—Complete calculations,details and specifications are required for each
heating,ventilation,humidifieation-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 cunstruction or remodeling is involved, a separate L�uilding 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
L__ _�heck All That A 1
[�Residential ❑ Commercial(Approval Required) [Backflow Device: ❑AVB ❑ PVB]
❑ New ❑ Additional ❑ Repairs ❑ Replace
Job Site i Owner Information:
Site Address: o��'�"� tAJ C-� �(;'1 Vl,t �G�.
Owner:�t'"��(L� � SS�Vl Mailing Address: �l�P�`l, l'.�LiC�� �UL bt.-�� (Z� •
City: CJ'L ti'V1,t� Zip: S S �`�1 (
Home Phone: Alternate Phone:
�Contractor Information:
Contractor: �� �vti��L�=-. 1 ��.��'��1�`� ��`71; � � (L�
Contact Person: l.^- �
J
Address: ��U� ��{V��l�V� ���� State Bond#:
�ity: j�� '�1�_ � ���� Zip.�jS�ZU Expiration Date: __
Phone: �SZ �� � � �1 ��1,`u Alternate Phone:
❑ Insurance—Current:
1
NIECHANICAL SYSTEMS BEING INSTALLED
Note: All Geothermal Systems will now require a Site Plan & Review by our Building Official.
IS THIS GEOTHERMAL? ❑ Yes ❑ No
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLiNG SYSTEMS
Quantity: �
Make: ��/YL�L�'�
Model: �V��'
Tons: �
H.Power
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) efm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Mr�st be approved by Fire MarshaU if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoar Grill ❑ Other/List What&Where:
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PERMIT FEE CALCULATIONS
l. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
� 0 �� � w x .0125 $ � �' L�
(contract price) (minimum$50.00)
2. STATE SURCHARGE
�� �i(� � �� X .000s � G �� �
(contract pricc)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ly`�- l.4'C1�
■ '` CGivTRHC i i-RiCE or JGB �OST rneans t;fe actuai or estimated dollar amount charged fer 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 otber party, the reasonable market value of such items must be added to the
estimated cost or contract price for permit fee purposes. ln 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.
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: ,� � 'Cl ���
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