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Home My WebLink About2016-01009 - mechanical CITY OF ORONO * Z 0 1 6 - 0 1 0 0 9 * 2750 KELLEY PARKWAY DATE ISSUED: 08/22/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2650 COUNTRYSIDE DR W PIN : 04-117-23-12-0014 LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN : LOT 006 BLOCK 002 PERMIT TYPE : MECHANICAL PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : HEATING SYSTEMS VALUATIOI�T : $ 6,900.00 NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. (1)DAIKIN NATURAL GAS FURNACE APPLICAIYT MECHANICAL 86.25 STATE SURCHARGE MECH(VALUATION) 3.45 CENTERPOINT ENERGY MAIL-IN FEE 2.00 6161 GOLDEN VALLEY RD BUILDING A TOTAL 91.70 GOLDEN VALLEY,MN 55422- Payment(s) (763)512-2765 CHECK 20507 91.70 Minnesota State License#: mech-MB003503 OWNER JORGENSON, ROBERT 2650 COUNTRYSIDE DR W LONG LAKE, MN 55356 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 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. � �/� Applicant Permitee Signature te Is ed Signature Date ��CEIV ED ou c► ��usr oN�.v City of Orono / ' l009 �O�O P.O.Box 66 �� O�rt Date Rece e� �� Permit# �l�" 2750 Kelley Parkway 0 G�)', � Crystal Bay,MN»323 Approved By: Amount$. �� Phone(952)249-4600 Fax 952) �, � LyTY�OF b�� F � l9kESH��G 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 will be sent by return mail after a review is completed. PERMITS ARE NOT VAL[D UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BECIN 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 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 Required) [Backflow Device: ❑ AVB ❑ PVB] ❑ New ❑ Additional ❑ Repairs ❑Replace Job Site/Owner Information: Site Address: 2650 COUNTRYSIDE DR W Owner: GERI JORGENSON Mailing Address: 2650 COUNTRYSIDE DR W City: �RONO Zip: 55356 Home Phone: 612-810-8996 Alternate Phone: Contractor Information: Contractor: CENTERPOINT ENERGY Contact Person: JOANN ZINKEN ACICII'eSS: 6161 GOLDEN VALLEY RD,BLDG A Stat2 B011d #: MB003503 City: GOLDEN VALLEY Zlp: MN EXp1CltlOtl �1t0: 08/20/2016 Phone: 763-512-��65 Alternate Phone: OLD REPUBLIC INSURANCE CO. ❑ WORKERS COMP&EMPLOYERS LIABILITY I11SUr111Ce—CUC►'e11t: POLICY#WLRCC48597075 oni irv oGoinn_n�in�nm�nvn�np�� 1 � , MECHANICAL SYSTEMS BE1NG INSTALLED Note: All Geothermal Systems will now require a Site Plan &Review by our B�iilding Official. IS THIS GF,OTHERMAL? ❑ Yes �]No HEATING SYSTEMS Quantity: --_�_ _—_ Make: DAIKIN Model: DM96VE1205DN Fuel: NATURAL GAS Flue Size: Input BTUs: 120,000 Output BTUs: 115,200 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(musC have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon lank in place.) ❑ Installation ❑ Remova] Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoar Grill ❑ Other/List What& Where: 2 PERMIT FEE CALCULATIONS 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) 6900.00 x .0125 �, $6.25 (contract price) (minimum S_50.00) 2. STATESURCHARCE __6900 00 _x .0005 �__ 3.45 __ (contract price) 3. POSTAGE& HANDLING (Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 91.70 ■ * 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. MECHANICAL PERMIT APPLICATION AGREEMENT The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do alt work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota,a��d certifies that all statements made on this application are complete,true and correct. Applicant's Signature: ' Date: 08/15/16 3 House heating test record ��enterPoint. Energy � Owne�-''1�� v�2�-,FjJ��V Controls Conversion Address��C> ��,�ti�.��t;,Wlhermostat f-4-�,'�J Heatplug Uent Size �� `�l� City��1V� l/alve �'�` Kind of liner/size `�� Heat loss Date h[g. inst C%�;�jS!((z�' Limit Draft hood Regulator Soldbv CenterPoint Energy Limitsetting 1'—�X�p Filters:Size��[.S , Number � Installed bv CenterPoint Energy Fan setting Chimney locations: ��Inside �Outside Electrical work by CenterPoint Energy Pilot type Chimney construction ��V�� Heat type (� FA Q Space heater Pilot make Wiring � rest tag � Gas line by �1'� Pilot model Lighting Inst '� Date tested�,�� Unit heater Other Pilot timing Com�any resrin4 CenterPoint Energy Gas design Pressure:Hi fire/Lo fire �� rester's name ��y 1D j� ��-f��-- Make��kj;�J Model pNl�i�+Vt, i�; Percent COz �j,'S' � InputCFH �'�4�� Percent0z ,�- c/' RECENED Serial no. �1(';(,i� (��,�j -��- ' Input �'1.,�1 t G�-� Stack temp �� Percent CO �� UG ? 'f z0�� C1TY O�ORONO CNP 235(11-2008) � � �-�-- �/ � DATE TIME CITY OF ORONO CALLED IN -�-�-�'�' INSPECTION NQ�TICE SCHEDULED �l 3 -� � /d; 'vv PERMIT NO. �"''� � ��a�� COMPLETED ADDRESS � ��- " s �- � �NNER � � LEPHONE NO. CONTRACTOR L�� - � �� DESCRIPTION i�"Z'�-(/1 CC C�Q �lil �-!' ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLIN(i �O ❑ FOUNDATION WATERPROOF ❑ PLUMBINCa FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT � ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL � ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 dWNERICOPITRACTOR TO MEET YOU:_YES_NO � COMMENTS: �l�- ��'� �`�-�6 � u�nac� re�/, - � � GJC(Sfi�rs��5 l/i'lG � ' � " �X�S�iKS 1/C�i�GG ° — Cb r� t ,•, i ro� — W � � - Q � 2 � I,Ja r K- c+or►,yol�t� � i�c�-� �:rt�,le� � � ❑YMORK SATISFACTORY:PFiOCEED ECT COMPLETE W ❑CORRECT VMORK�PROCEED ❑ISSU EATiFICATE OF OCCUWINCY O O CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFORE CdNERINO PERMANENT ❑CORRECT UNSAFE CONDITION WRHIN HWRS. O PHOTO TAKEN iNSPECTOR W{LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �GTATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. CsN for the next inspectfon 24 hou in aa�►ance. (952) 249-4600 OwnerlConiractor on site: Inspector: ` YVhite yAnapsetor's Fil� C�nary CopylSlb Notic�