HomeMy WebLinkAbout2015-01039 - mechanical CITY OF ORONO * Z 0 1 5 — 0 1 PJ 3 9 *
2750 KELLEY PARKWAY DATE ISSUED: 08/17/2015
�� ORONO, MN 55356-
� 952 249-4600 FAX: 952) 249-4616
ADDRESS : 85 FERNDALE GREEN
PIN : 36-118-23-44-0024
LEGAL DESC : ALLO-RAE TERRACE
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES- MULTIPLE
VALUATION : $ 9,000.00
NOTE: 1 HEATING SYSTEM(GOODMAN), 1 COOLING SYSTEM(GOODMAN)
APPLICANT MECHANICAL 112.50
STATE SURCHARGE MECH(VALUATION) 4.50
BLUE OX HEATING&AIR MAIL-[N FEE 2.00
5720 INTERNATIONAL PKWY
NEW HOPE, MN 55428- TOTAL 119.00
(612)238-9709 Payment(s)
Minnesota State License#:mech-MB671957 CHECK 10969 119.00
OWNER
POWERS,JOHN&ROXANNE
85 FERNDALE GREEN
WAYZATA, MN 55391
AGREEMENT AND SWORN STATEMENT
The work for which this permi[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 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 I 80 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 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 cause. _ (� �,�
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Applicant Permitee ig atu Date Issued By Signature Date
ck$11�9 job286687 P0803461
�_` FOR CITY USE ONLY
� City of Orono
� ' � � P.O.Box 66 Date Received' ��"��'j Pennit# Za� �Q` � 3 �J
, � 2750 Kellcy Park�vay /
Crystal 13ay,MN SS323 Approved B��� � Amount$: � � 9 •
Phonc(9�2)249-4600 Pax(9�2)249-4616
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�qk�S�{��e.�' CITY OF ORONO—MF.C�IANICAL YLRMIT
_�_ (All Commercial pennus must be approved b� the 13uilding Ot�t�icial or]nspector and/or I�ire Marsh�ll)
GENERAL INFORMATION
1. You may apply f'or mechanical permits by mail or in person at the City offices. Applicatio��s 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. PERMI'1'S ARE N07'
VALID UNT[L YOU RECEIVE A PERMIT. WORK MUST NOT BF,GIN UNTIL THF.
PF,RMIT CARD IS POSTFD ON TIIE JOB SITF,.
3. Mechanical Desi�ns—Compiete 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 1
❑� Residential ❑ Commercial(Approval Rec�uired)
❑New ❑Additional ❑ Repairs ❑■ Replace
Job Site/Owner Information:
s�te aaaress: 85 Ferndale Green
Roxanne Powers "
Owner: Mailing Address:
n n
City: Zip:
Home Phone: 952-473-� 39� Alternate Phone:
Contractor Information:
Blue Ox Heating & Air Jennie Wood
Contractor: Contact Person:
5720 International Pkwy MB671957
Address: State I3ond #:
New Hope MN
City: Zip: Expiration Date:
612-238-9709 "
Phone: Alternate Phone:
❑ Insurance— Current: Owner's Insurance
x
1
, , MECHANICAL SYSTEMS BE1NG INSTALLED
' Note: All Geothermal Systems will now require a Site Plan & Review by our Building Official.
IS THIS GEOTHERMAL? ❑ Yes ❑� No
HEATING SYSTEMS
Quantity: 1
Make: Goodman
ModeL• GME810005CX
FU��: gas
Flue Size:
Input BTUs: 1��k
Output[3TUs:
CFM:
COOLING SYSTEMS
Quantity: _1
M�ke: Goodman
Model: GSX130361
Tons: 3
H. Power
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILA'TION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FtIEL 5'TORAGE (Must be approved by Fire Mnrshall if proposing 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&Where:
2
� PERMIT FEE CALCULA"TION(S) �
BASED OFI� -2002 STATE STATUE
❑ Ycs,this section applies
The replacement of a Residential fixture or appliance that mects all three orthe following re�uirements:
1. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludine 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-]n Fee(If Applicable) $ 2.00
Total Pcrmit Fec $
�--��- _ PERMIT FEE CALCULATION(Sj -�OBS QVER $SG0.00 � �
If above does not apply; follow guidelines bclow:
l. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fce of$50.00)
9000 x .o,2s $ 112.50
(contract pricc) (minimum$50.00)
2. STATE SURCHARGE
9000 X .000s $4.50
(contract price)
3. POS'TAGE&HANDLWG (Only on Mail-In Applications) $ 2.00 _
4. T07'AL PER11917' FEE(Add Lines 1-3 Above) $ � �9
■ * 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.
� M�CHA�IC�I, PERMI'I,�APPLICATION�AGREEIV��NT ' � �� �
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 n th' a plication are complete, true and
correct.
i
°�/ 7/30/15
Applicant's Signature: Date:
3
�s3 1
DATE TIME\ �
CITY OF ORONO CALLED IN
INSPECTION OTIC SCHEDULED 11- { �,�CY- —
PERMIT NO. I • ��O 3G COMP ED
ADDRESS � ��►�v"�� ����
OWNER T LEPHONE NO�� �� ` �a�
CONTRACTOR �3 � �
� DESCRIPTION � � �
lN ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ��t ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ ME�HA_N�AL RI ❑ SITE INSPECTION
Q ❑ FRAMING "�MECHANICAL FINAL} ❑ RATED WALLS
� ❑ INSULATION �W�OD 6�JRNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
? ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO � ��� '�jPt�
y COMMENTS: / Yc�fS-
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W� ❑WORKSATISFACTORY:PROCEED OJECT COMPLEfE
W ❑CORRECT VYORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALI FOR REtNSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WlLL REfURN ❑CITATION ISSUED
❑STOPORDER POSTED.CALI INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlCoMractor on site:
Inspector �
White Copyllnspector's Ffle Cenary CopylSite Notice