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Home My WebLink About2016-01005 - gas line only CITY OF ORONO * 2 0 1 6 - PJ 1 0 0 5 * � 2750 KELLEY PARKWAY DATE ISSUED: 08/19/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 200 BAYSIDE TR PIN : 06-117-23-22-0027 LEGAL DESC : BAYVIEW FARMS 2ND ADDN : LOT 2 BLOCK 1 PERMIT TYPE : MECHANICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY VALUATIOI�1 : $ 1,200.00 NOTE: ALL TESTMG REPORTS SHALL BE ON SITE AT FINAL INSPECTION. GAS LINE TO GENERATOR THROUGH FINISHED CELING SPACE UP TO 95' APPLICANT MECHANICAL 52.00 STATE SURCHARGE MECH(VALUATION) 0.60 PRACTICAL SYSTEMS TOTAL 52.60 4342B SHADY OAK RD HOPKINS, MN 55343 Payment(s) (952)933-1868 CHECK 8719 50.60 CHECK 8719 2.00 OWNER HOLLOWAY&MELISSA KUKLOK,CASS 200 BAYSIDE TR MAPLE PLAIN, MN 55359- 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 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time afrer 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. , �- � j � - � C , - , _ /j - , ; r �l �.. C7� ---- ` � ' ✓l/ ' ` \. ' �1 ` �' � � � 1 / '((,. ' �le /c • . 'J 1�� ..4 � A�4plicant Permitee Signatu Date Issued y Signautt�e Date ' FOR CITY USE ONLI' �O A' City of Orono �i� Z C��„ �y� P.O.I3ox66 DateReceived: �_ pe�nit# � � Vfi ��'�� 2750 Kelley Park�c�y Crystal[3ay,MN 55323 Approved By: � Amoimt$: . ��) Phone(952)249-4600 Fa�(952)2-19--1616 a a Z � F � ��'�£SHn��G CITY OF ORONO—MECHANICAL PERMIT (All Commercial pem�its must be approved by the Building Official or Inspector and/or C ire 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 VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desiens—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 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 ) �12esidential ❑Commercial(Approval Required) ❑ New ❑ Additional ❑ Repairs ❑ Replace Job Site /Owmer Information: Site Address: � � �C�-E ' Owner: � S� Mailing Address: I.:�C.U' �Jl��' (��L-�, ' c►ty: �(l�'� zip: 5� � Home Phone: �:�(' 1:�, � �'�� Alternate Phone: Contractor Information: . � Contractor: ��C��C� 5��ontact Person: �'�� (it�� Address: �-E-�� , �L�f�-`�-State Bond#: �.�,�J��(� City: � Zip:�pV Expiration Date: � � �� Phone: �� J��— �g�QQ Alternate Phone: ❑ Insurance—Current: 1 MECHANICAL SYSTEMS BEING 1NSTALLED Note: /111 Geothermal Systems will now require a Site Plan & Review by our Buildin� Oflicial. IS THIS GEOTHERMAL? ❑ Yes ❑ No HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: Input BTUs: Output BTUs: CFM: COOLING SYSTEMS Quantity: 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 Exhaust duct recirculating cfm ❑ No. Bath Exhaust(must have duct outside) cfin ❑ No. Other Fans: Locations cfm FUEL STORAGE (Must be upproved by Fire Marslia/l rf proposing to ahnndon tm�k in pinee.) ❑ lnstallation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑Outside LP Gas: gallons Other: GAS LINE ONLY �� I�� ❑ Outdoor Grill Other/List What&Where: �%'� � T� 1�� 2 ��ll �l, C�( � �1C� ��C,�� c.�.�� c�� . PERMIT FEE CALCUI..ATION(S) � BASED OFF - 2002 STATE STATUE ❑ 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;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-In Fee(If Applicable) $ 2.00 Total Permit Fee $ � ''°`PERMIT F� CALCUL�TION S =rdBS OVER �� , .� ;`_' � ry�_` 'v,{ `�' �� ._ � . � , � . �� , _ �� ,�,,,��- [f above does not apply;follow guidelines below: � ��` 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) �/� �\ j�� C � � , �l�C.i i �U x.0125 $�''`.Jl ' � ��i �� - � (contract price) (minimum$50.00) 2. STATE SURCHARGE � � ✓�� x.0005 $ � �� O( (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.� 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. [t 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 ar contract price for permit fee purposes. [n 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. � . - � ,;= �IEC = � °ti N AGREEME ,a` The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all work in strict accordance wi the ordinances of the City and the regulations of the State of Minnesota, and certifies th all statements made on this application are complete, true and correct. Applicant's Si nature: ✓ te: �j 3 � � �"� DATE TIME / \. CITY OF ORONO CALLED IN INSPECTION N TIC�� SCHEDULED � PERMIT NO. connP�ErE� ADDRESS � ��`� � tilvs 1�z- �—�_2J� , OWNER TELEPHONE ;7So� �I�3/�(�/ CONTRACTOR � S� ' � ��,� �r �PS� �: DESCRIPTION ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL I J ❑ DEMO-SITE ❑ TIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU: YES_NO c�., COMMENTS: � _ a �.� /,�� -�a r �7��l c �wt r — O - 4 6� Gd�JD ✓ �4�J'�d 9 ' >. � � ' f45 /.�t e. q.i �C� /G /�0�'`K � W � Q � D ^ � 7/r/�S�C, lhS�c� 14C✓ W �� 2 J � �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE w� ❑CaRRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WFLL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-46�0 OwnerlContractor on site: Inspector. � c./ White Copyllnspector's Ffle Canary CopylSite Notice r�� P � �i�v�DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTI E�_ ��r��c'� SCHEDULED __��i �ERMIT NO. ��ti`�-' COM�LETED ADDRESS OWNER TELEPHONE N ��a �3�� CONTRACTOR �-C-� -� Z �� ' 1 � DESCRIPTION ^� � � ' ��r W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT v r�1NAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W _ ❑ AS BUILT-SURVEY SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE EPTIC INSTALL 2 ONfNERlCONTRACTOR TO MEET Y'OU: YES_NO v�i COMMENTS: � W a o ---�/l �+� �b,xm/,�u �.r �,o��s b�. �. � 0 � w � Q � W � W � j � ❑VYORK SATISFACTORY:PROCEED ��OJECT COMPLETE � ❑CORRECT VYORK 3 PROCEED ❑1 UE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CO'VERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-46�0 OwnerlContractor on site: Inspector. C�� i.� �(--- � . White CopyAnspector's File Canary CopylSit�Notice