HomeMy WebLinkAbout2015-00812 - mechanical � .
CITY OF ORONO * z 0 1 5 - 0 0 8 1 z *
2750 KELLEY PARKWAY DATE ISSUED: 06/23/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 3630 EILEEN ST
PlN : OS-117-23-21-0013
LEGAL DESC : RIEDEL CO STUBBS BAY ADDN
: LOT 003 BLOCK 001
PERMIT TYPE : MECHAN[CAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL- MULTIPLE
VALUATION : $ 8,000.00
NOTE: (1)CARRIER HEATING SYSTEM
(1)RENEWAIRE HEATING SYSTEM
(1)CARRIER A/C
(1)APPILAIRE A/C
(30 BATH EXHAUST
GASLINE FRONf METER TO FURNACE
APPLICANT MECHANICAL 100.00
STATE SURCHARGE MECH(VALUATION) 4.00
GENZ-RYAN PLUMBING& HEAT MAIL-1N FEE 2.00
2200 HIGHWAY 13
BURNSVILLE,MN 55337 TOTAL 106.00
(952)767-1000 Payment(s)
CHECK 148064 106.00
OWNER
MCCUTCHEON, MARK&JAYME
3630 EILEEN ST �
MAPLE PLAIN, MN 55359-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according[o
the approved plans and specifications,applicable City approvals,and Ihe
S[ate Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permi[s. Al)provisions of laws and ordinances governing this type of work
shail be compied with whe[her 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 l80 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 Signature Date [ss ed Signature Date
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FOR CITY LiSE ONLY
n �" ." ------� Ci of Or v
1� I�J Uj �� �ON`� P.O.Box 66 ���'`�� Date Received: Permit#
� �� 2750 Kelley ParkN�a��
Crystal Bay.MN„5,�2�� q��� Approved By: Amount$:
���� I Phoiie(952)24A�f�l (4 49-4616
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`� �,` ' Q�'T''�'��I��NO— MECHANICAL PERMIT
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���5 f��� (.�II Com��cial 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
VALID UNTIL YOU RECEIVE A PERM[T. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desi�—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air conditioning installation including
heat loss/heat gain calculation,design te�r�peratures,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)
�]New ❑ Additional ❑Repairs ❑ Replace
I�
Job Site/Owner Information:
Site Address: ���:���U �,,�� S�.x,(1 ��
l�' . /'
Owner: � � ��� �'U� ��i�� Mailing Address:
City: _;�__����,�� Zip: ,)�3 ��
Home Phone: Alternate Phone:
Contractor Information:
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Contractor: '� ') � L � , Contact Person: � .', � 1 �� � ��,'�
Address: ��l � ��� ���� State Bond #: ,J ' � � ���' �
City: �� ���� �' � Zip: ,���Expiration Date:
Phone: �����=��11 '����%�� Alternate Phone:
❑ Insurance—Current:
1
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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: �
Make: � ��� I j�" �� ��I.�!`�
Model: ������0��� E v 2,1��J
Fuel: �� � ��(� �.�(V"
4 � � �
Flue Size: �2 �'� �'�1' ,,�
Input BTUs: ` ��v�4
Output BTUs U �
CFM:
COOLING Sl"STEMS
Quantiry: � � •
Make: �}„� �J��'� ������ �h 1��'. � :
Model: �,I�'�Zy � �,U.J3W�"�3 11X1 F�1�
Tons: � "11h 1uP.���L , •
�. Q �� � (
H. Power ��1 ��Y '
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) �cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be a�proved by F[re MaYslan!l ijproposing to abandon tnnk in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLl'
❑ Outdoor Grill ❑ Olher/List What&Where:�(�' ��•�M/���i�.�,( �,,(,���{(}2
2
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PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
❑ Yes,this section applies
The replaceir�ent 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; excluding 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([f Applicable) $ 2.00
Total Permit Fee $
PERMIT FEE CALCULATION(S)—JOBS OVER $500.00
If above does not apply; follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
��
x .O125 $ lu��
(co ract price) (minimum�50.00)
2. STATE SURCHARGE � �� ��� �;�
x .0005 $
(co�tract price)
3. POSTAGE&HANDLING(Only on Mail-I►7 Applications) $ 2.00
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4. TOTAL PERMIT FEE(Add Lines 1-3 Above) �
■ * CONTRACT PRTCE 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 fior 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 coi�nplete, true and
correct.
� � _
Applicant's Signature: �'���� �� � Date: � �� � ��
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�/ � � DATE TIME f
CITY OF ORONO CALLED IN �� —�—��
INSPECTION O IC ��/�SCHEDULED 7�%� 4 •.7��
PERMIT N�� � CONTPLETED
ADDRESS � �
OWNER TELEPHONE N0.7i�C.-����0��
CONTRACTOR
� DESCRIPTION �/ �-���
lV ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB �` A�CHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERlCONTRACTOR TO MEET YOU:_YES_NO '
� COMMENTS: /"1/I•L . ' ��pp/�as , ��tcs�.cs - •t��
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W G WORKSATISFACTORY:PROCEED " ❑ PROJECT COMPLETE
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�,/�C1`6ARRfCT WORK&PROCEED (� .� Y ❑ ISSUE CERTIFICATE OF OCCUPANCY
�y C7 CORRECT WORK,CALL FOR REINSPECTI���«�4���,i TEMPORARY
�
� BEFORE COVERING �� PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call fo t inspection 24 hours in advance. (952) 249-46�0
Ownerl ontractor on s' : �"t�'¢
Inspector. �-
White Copylinspector's File Canary CopylSite Notice
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DATE TIME
CITY OF ORONO ' CALLED IN f D-Z�7
INSPECTION N T C ��g/�CHEDULED !�-��'S ./ : 3C�
PERMIT NO. � COMPLEfED
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ADDRESS �� ��-�-���n- � '
OWNER '� TELEPHONE NO. �a� �(07-�p38
CONTRACTOR �
� DESCRIPTION �"� �"`''`-
llr ❑ 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 �pQECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ��❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
v�i COMMENTS: '�s /�'��3 ,fj c••t0��'✓ C�.a��tc.��./
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W ❑WORKSATISFACTORY:PROCEED �J'�PRpJECT COMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
w
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspecti�24 hours in advance. (952) 249-46�0
OwnerlContract on site: �
Inspector. �^-�
Whi e Copyllnspecto�'s File Cenary CopylSite Notice