HomeMy WebLinkAbout2011-00016 - mechanical � R.+}
CITY OF ORONO PERMIT NO.: 2011-00016
� 2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE issUED: O1/OS/2011
952 249-4600 FAX: 952 249-4616
ADllRESS : 1985 FAGERNESS POINT RD
PIN : 18-117-23-14-0004
LECAL DESC : FAGERNESS
: LOT 003 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PRONERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL- MULTIPLE
VALUATION : $ 12,000.00
NOTE: HGATING SYSTEM-LUXAIRF_-NATURAL GAS-2" 1'LUG-80,000 13�'U'S INPUI', 7�,000 13'I�U'S OUTPUT, 12,000 CPM
COOLING SYS'I�EM-LUXAIRE-MODt�:I,-TG36-3"I�ONS- 1/3 I1. POWER
(I)KITCtIEN GXI IAUS'I�- I DUCT-6"-300 CFM
(3)E3ATH EXIinC'ST-60 C1=M
APPLICANT MECHANICAL 150.00
E3EN SCHORER PLUMBING & HVAC INC. STATE SURCHARGE MECH (VALUATION) 6.00
4�_0 B�TH S"I'REET SE
DELANO, MN 55328- TOTAL 156.00
(763)972-8I37
OWNER
BRIGGS, MATTHEW& ALISSA
1985 FAGGRNESS PT RD
WAYZA"��A. MN 55391-
AGREEMFNT AND SWORN STATEMENT
The���ork ibr���hich this permit is issued shall be peribrmed according to
the approved plans and specitications,applicable City approvals,and the
State[3uilding Code. This permit is for only the work described and does
not grant permission for additional or rclated���ork�rhich requims separatc
permits. All provisions of laws and ordinances governing this type of work
shall be compied with�vhether or not specified herein.This permit���ill
expire and becomc null and void if construction authorized is not
commenced N�iUiin 180 da��s of the date of issuancc,or if construction is
suspended for a period of 180 da}�s at any time xlter work has commenced.
Thc applicant is responsible for assuring all required inspections are
requcsted in conlormanee with the Slate f3uilding Code."fhis permit may be
revoked� nv time for due cause.
�z� � / l S i�-w� / l J� l /
Applicant Pcrmitee Signature Date I:, d By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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/ FOj2 CIT USE ONLY
,��� City of Orono f/ i /
O O P.O.Box 66 Date Received� � � Permit# a���' Q��v
I � ,, 2750 Kellcy Parkway
�� ,1 j'�,--- yF Crystal Bay,MN 55323 Approved By: Amo�mt$:��.
�� 'i�F�jr'�4.�o Phone(952)249-4600 Fax(952)249-4616
�sesos
CITY OF ORONO-MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector and/or Fire 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 wil]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 Desi�ns—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 ratiubs 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 liniform 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 Apply)
� Residential ❑ Commercial(Approval Required)
� New ❑ Additional ❑ Repairs ❑ Replace
Job Site / Owner Infornlation:
Site Address: � � 3�� `�"�j y+ �"-S� /�v,ti��` �c�'�
Owner: Mailing Address:
City: �'� ' ����� Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: ����� S�-� r=�" �� �� Contact Person: ��e��� � :-��k�����
r
Address: `�5 Z� � �� 5�� 5�' State Bond #: -��-.3 3� ��� a
City: ���� Zip: �� Expiration Date: I U '��- � ����
Phone: �sz� ���;�'��.- `7 �l r�
� Alternate Phone:
❑ Insurance- Current:
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� MECHANICAL 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: t
,
Make: ;.u kc.-;f �
Model: ` ���
Puel: �Gti�=
Flue Size: �,,
Input BTUs: ��,0�''D
Output BTUs �7S,QoU
CFM: 1 a�C�aC
COOLING SYSTEMS
Quantity: �
Make: L c�}��,�,1 e
Model: '�C7 3 �
Tons: 3
H. Power �3
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILATION
[� No. � Kitchen Exhaust � duct �9 � rec�ating ���' cfm
� No. __� Bath E�aust(must have duct outside) �cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must he approved b}�Fi��e Marshall if proposi�rg to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LInE ONLY
❑ Outdoor Grill ❑ Other/List What 8& Where:
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PERMIT FEE CALCULATION(S) �
BASED OFF - 2002 STATE STATUE �
❑ �'es, this section applies
The replacenlent of a Residential fiatw-e or ap�liance that meets all tllree of the following requirements:
1. Does not require modification to electrical or gas service.
2. Has a tota] cost of$�00.00 or less; excludin�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 $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
PERMIT FEE CALCULATION(S) '-JOBS OVER �500.00
If abo��e does not apply; follow guidelines belo��:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
( ,�'�d�C� x.0125 $
(contract price) (minimum$50.00)
2. STATE StiRCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of�5.00)
x .0005 $
(contractprice) (minimum�5.00)
3. POSTAGE &HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PER�'IIT FEE (Add Lines 1-3 Above) $
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
peinutted 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 puiposes. In the event that there is a dispute on the
amotmt of the job cost, the City may request the submission of a signed copy of the actual contract.
■ ** The STATE SURCHARGE is .0005 times the Contract Price or a minimum of�5.00.
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
con-ect.
c�-.� �,
Applicant's Signature: ��'�-' �G-�� Date: � ��-���
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