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Home My WebLink About2012-00509 - mechanical CITYOFORONO * 2012 - 00509 * 2750 KELLEY PARKWAY DATE ISSUED: 06/08/2012 � ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 1055 FERNDALE RD W PIN : 02-117-23-43-0029 LEGAL DESC : N/A : LOT MB BLOCK MB PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : MECHANICAL- MULTIPLE VALUATION : $ 6,485.00 NOTE: I LENNOX NATURAL GAS FURNACE I LENNOX 3 TON AC APPLICANT MECHANICAL 81.06 SELECT MECHANICAL SERVICES INC. STATE SURCHARGE MECH(VALUATION) 3.24 6219 CAMBRIDGE ST ST. LOUIS PARK, MN 55416- MAIL-[N FEE 3.76 (952)926-4488 TOTAL 88.06 OWNER MCCOURTNEY, GERALD& KAREN 1055 FERNDALE RD W WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specitications,appiicable 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 180 days of the date of issuance,or if construction is suspended for a period of l 80 days at any[ime 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. `_l�a-� `'� l l l l Applicant Permitee Signature Uate Issued By S' ature ate SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED ABO . �'"' A FOR CITY USE ONLY ! �� City of Orono P.O.Box 66 Date Received: Pemut# � �� 27�0 Kelley Parkway � ��r"` � 1 ��i �,- I��) Crystal Bay,MN�5323 Approved By: Airtauni$: '��„#�oc (952)249-4600 CITY OF ORONO-MECHANICAL PERMIT (All Commercial permits must be approved by[he Bwlding Offiaai or tnspector and/or Eire 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 aftec a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERM[T. WORK MIiST NOT REG1N 11NTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desians—Comp(ete calculations,details and specifications are required for each heating,ventilation,humidification-dehumidification,and air conditioning installation including heat loss/heat gain calcuiation,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 s�parate building permit must be obtained. 5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code requirements. 6. Alt work must be inspected(rough-in and final). Call(952)249-4b00. (24-48 hour notice required) 7. House Heating Test Record must be submitted before final. TYPE OF PERMIT Check All That A 1 ' �gResidential �Commercial(Approval Required) / � ❑ New ❑ Additiona( ❑ Repairs �Replace Job Site/Owner Information: Site Address: �� ('N�D•�� ,/) Owner:V�2A�/� '�t��--�� Mailing Address: City: D��c� Zip: Home Phone: ��' '��o�U Alternate Phone: Contractor Information: Contractor: J��-�-Z-i 1 u�Ck6A�NIfA(, Contact Person: �,�y�(l.`��P.�1�/A Address: �a'�� -��4�b��`T' State Bond #: ��--��l� City: � vt� ? �-- Zip: ��C� Expiration Date: � lo IZ, _ Phone: q ��'�T�" ��SU Alternate Phone: �� r��,�'��S� ❑ Insurance- Current: .�/� b�f 0��--�p/ 1 � � � }' N,�1�y� ��.. -4 � ,✓K . -5... i1M^: ,.Y 4`� '::4YY�V1�, 'y,��i'� � Note: All Geothermal Systems wiil now require a Site Plan & Review by our Building Official. IS THIS GEOTHERMAL? ❑ Yes �No HEATING SYSTEMS Quantity: ( Make: l�G1NNDyC Model: �L a�(o�� Fuel: N.G Flue Size: 2��a/C� input 87L's: �Si�Y� Output BTUs: �3r� CFM: �o�E�� COOLING SYSTEMS Q�ts�,,: � Make: ��_ Mode1: � Tons: H. Power FIREPLACES ❑ Gas Factory Fireplace Brand Name: ❑ Wood Buming Fireplace B Wood Stove Modef No.: ❑ Wood Stove With Flue VENTILATION ❑ No. Kitchen Exhaust duct recirculating cfm ❑ No. Bath E�chaust(must have duct outside) �� ❑ No. Other Fans: Locations �� FUEL STORAGE (Must be approved by Fire Marsha!!ijproposing to abandon tank in place.) ❑ Installation � Removal Fuel OiL gatlons ❑ Underground � [nside � Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill � Other/List What& Where: � / � f'I� / : PERMIT FEE CALCULATION(S) !BASED OFF -2002 STATE�TATUE ❑ Yes, this section applies The replacement of a Residential fixture or anpliance that meets al]three of the following requirements: 1. Does not require modification to electricai or gas service. 2. Has a total cost of$500.00 or less;excludin�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 $ 22.00 � PERMIT FEE CALCULATION(S)-JO S OVER$500.00 -� If above does not apply; follow guidelines below: I. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) ��/5S� X .oi2s $ � �. � (contract price) (minimum$50.00) 2. STATE SIIRCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of55.00) �f../ / ( �� x.0005 $5.00 (contract price) (minimum S 5.00) 3. POSTAGE& HANDLING(Only on Mail-ln Applications) $ 2.00 4. TOTAL PERMIT FEE (Add Lines 1-� Above) $ ��O� • * 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 Ciry may request the submission of a signed copy of the actual contract. ■ ** The STATE SURCHARGE is .0005 times the Contract Price or a minimum of$�.00. MECHAl'�ICAL PERMIT APPLICATIQN AGREEMENT 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 Ciry and the regulations of the State of Minnesota, and certifies that all em' nts made on this application are complete, true and conect. ,-, Applicant's Signature: � Date: � �l 'z Reset Form 3 �� TE TIME " CITY OF ORONO CALLED IN � � INSPECTION�IjJQ��E D�D� SCHEDULED ' « o�--� PERMIT N0.°«� D COMPLETED ' , J ADDRESS ��SS ��if�yc��Q � �(/ - OWNER ��-�TELEPHONE NO. /�Z r 7� �� CONTRACTOR ��'�� > >; DESCRIPTION � � � ❑ FOOTING ❑ PIUMBING FINAL ❑_ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL � SEWER HOOK-UP � COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL IC LL ❑ HARD COVER REMOVAL J ING ❑ SEPT FI ❑ FOUNDATION/REMOVAL Z OWNER/ ONT ACTOR T MEEf YOU: ES_NO � MMENT . � W � � J O >- � O � W � Q � Z W � W � j GW ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOl1RS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR � INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (J52) 249-4600 OwnerlContractor on site: Inspector. ,�o � �� White Copyllnspector's File Canary CopylSite Notice