HomeMy WebLinkAbout2016-00330 - mechanical � CITY OF ORONO * z 0 1 6 - PJ 0 3 3 0 *
2750 KELLEY PARKWAY DATE ISSUED: 04/14/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 627 FERNDALE RD N
PIN : 36-118-23-11-0029
LEGAL DESC : LAURENT ADDN
: LOT 000 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 2,400.00
NOTE: 1 GARAGE HEATER(MODINE)
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.20
THE FIREPLACE PROFESSIONALS TOTAL 51.20
5297 KAHLER DRIVE NE Payment(s)
ALBERTVILLE,MN 55301 CREDIT CARD 5953 51.20
(763)238-9036
Minnesota State License#:mech-MB004932
OWNER
JOHNSON,BONNIE
627 FERNDALE RD N
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 Ihe 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 nuil and void if construction authorized is not
commenced within 180 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 ith the State Building Code.This permit may be � %�
revoked at an time e cause )
c
/�%�16 l� ���'�L' � �
� I'� I b
p �cant Permitee Signature Date Issued By Signat Date
` FOR CITY USE ONLY
City of Orono 1 �
�0�� P.O.Box 66 Date Received: ��r�'.1��Q,_ Permit# � r U 33V
2750 Kcllcy Parkway �
C�ystnl Ray,MN 55323 Approved 13y: _��Amount$: f,n� :
Phone(952)249-4600 Fax(952)249-4616 �iJ�
' � �
y ;
F� �.� CITY OF ORONO—MECHANICAL PERMIT
�kt S H�� (All Commercial pertnits must bc approved 6y the Building Offieial or Inspector ancUor Fire Marshall)
�__�
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City o�ces. Applications wiil
be reviewed and a permit�vili be issued within two working days.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTII..YOU R�C�1VE A P�RMIT. WORK MUST NOT BEGIN UNTIL TT�
PERMiT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desi�ns—Complete calculations,details and specificarioos are required for each
heating,ventilation,humidification-dehumidification,and air conditioning installatio�including
heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to
type,manufacturer and modei. Data shall be presented on form provided.
4. When any new const�uction or remodeling is involved,a separate building permit must be
obtained.
5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code
requirements.
6. All work must be inspected(rough-in and final). Call(952)249-4600.
(24-48 hour noticc required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
(Check All That Apply)
�Residential ❑Commercial(Approval Required) [Backflow Device: ❑AVB ❑PVB]
❑New ❑Additional ❑Rcpairs ❑Replace
Job Site/Owner Information:
Site Address: C.��f /-"�'!",,C.��r��� I�C�� �c��t
Owner: . � L� c.� Mailing Address: �� ,�t�� fti�� i�
�
City_ ����E7 Zip: .�.�. �11
Home Phone: Alternate Phone:
Contractor Information
Contractor: �r,,�i�,�,n�,�� /'%�ss=;�,i� Contact Person: ��1Svx,� �r4�uelSrx.�
J
Address: :�'�� �,^i �t.',1 �o fV�. State Bond#: 1���y�.3oZ
City: � ��f�v,IIc. Zip• c7 �xpiration Date: L��/�� /,�(�I �
Phone: 7��`<��.�"��>�'_ Alternatc Phone:
r� Insurance—Current: Q��-� � 'p����
1
, { `.1VIECHANICAL;SYSTEMS$��Cr,°�NS'I"AI�LED. '� ° `
• Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes �No
HEATING SYSTEMS
Quantity: /
Make: �fC�i.UG'...-
Model: �j�,��i��
ruel: �� '
. Flue Size: �'�
Input BTUs: fiY✓a�� I
Output BTUs: I'
CFM:
I
COOLING SYSTEMS �
Quantity: I
Make:
Model:
Tons:
H.Power
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen E�chaust duct recircutating cfm
❑ No. Bath E�aust(must have doct outside) cfm
❑ No. Other Fans: Locations cfm
FIIEL STORAGE (Must be approved by Fire Marshal!if proposing to abandon tank in place.)
❑ lnstailation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: galions
Other.
GAS LINE ONLY
❑ OuWoor Grill ❑ Othcr/List What&Whcrc:
2
, �
• PERMIT.E"E�C�LG'fJLATION5 .,: ;, „ � �`
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
��,��� ���'✓ x.0125$ .3C�� J
(contractprice) (minim m S50.00
2. STAT`E SURCHAKGE r�)
.�`��-� �`� x.0005 $ � J�C�
(contract price)
3. POSTAGE&HANI7LING(Only on Mail-In Applications) $ 2. �
4. T�TAL PERMIT FEE(Add Lines 1-3 Above) $ �� � � I
■ �` 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 installaUons 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 conhact.
„ ,
�: ,. .�,,.,, � �c�c�:,�E�r ArrilcAT��a�r�,G��zv��T $���=4 ,.� �;'�;,
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 stateme�nt}nade o this application are complete,true and correct.
L%;',�'�%
Applicant's Signahue: .�..: f "'�.-.,��.��>_ Date: 7� '��-��
3
_