HomeMy WebLinkAbout2016-01081 - mechanical , CITY OF ORONO * 2 0 1 6 - PJ 1 0 8 1 *
2750 KELLEY PARKWAY DATE ISSUED: 09/06/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2195 FRENCH LAKE RD
P[lv : 10-117-23-21-0006
LEGAL DESC : JOHNSTONS FRENCH LAKE 2ND ADDN
: LOT 001 BLOCK 003
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 650.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
INSTALL(2)BATH FANS -MAIN LEVEL POWDER ROOM AND MAIN LEVEL KIDS BATHROOM
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 0.32
KLEVE&JC MECHANICAL LLC MAIL-IN FEE 2.00
12907 PIONEER TR
EDEN PRAIRIE,MN 55347- TOTAL 52.32
Minnesota State License#: mech-658861 lb PC646240 Payment(s)
'p g CHECK 13408 52.32
OWNER
DALTON, MICHAEL&JENNIFER
2195 FRENCH LAKE RD
WAYZATA, MN 55391-
AGREEMENT AIVD SWORN STATEMENT
The work for which this permit is issucd shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State duilding Code. This permit is for only the work described and does
not grant permission for additionai 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 specitied 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.
� Gj' , lo , J (o
Applicant Permitee ignature Date Issu d y Signature Date
FO CITY USE ONI,Y
�O�\�\ City of Orono RECE'v �1/�p permit# �1�/ � `��
� P.O.Box 6G ate Recei��e
Q �� 2750 Kcllcy Parkway
�� ` Crystal Bay.MN 55323 (� 7O'� Approvcd By: Amount$:
� Phone(952)249-4600 Fax(��249-4�IS
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��qhFSH���E.� CITY ��IR51���ECHANICAL PERMIT
�_ (All Comntcrcial permits must bc approvcd by thc Building Official or Inspcctor and/or Firc 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 S1TE.
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 forn�provided.
4. When any new construction or remodeling is involved,a senarate 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 )
�esidential ❑ Commercial(Approval Required) [Backflow Device: ❑AVB ❑ PVB]
❑ New ❑Additional ❑ Repairs ❑Replace
Job Site / Owner Information:
Site Address: �1�J �� N�����}'�..E �DA�
Owner: `1/I ( �.E ��•`�1V Mailing Address: Z�� �Q.ENC4� L�'�' �fi�
City: ��ZA-'�A Zip: ^5�3�
Home Phone: Alternate Phone:
Contractor Information: �-
' J�-'nn�
Contractor: k��1/E ;.j'C MECHI�r��CqL�t-�C.Contact Person:
Address: � q0� ON EE�'R�h L State Bond #: rl�Ih ID5�g�0�
�3�� -� r 3� ��
City: �� ���Zip: �IN Expiration Date:
Phone: IS� ��'II �Z I I Alternate Phone:
❑ Insurance —Current: ��'s'i�'Q,���'(�n,p/�,
1
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:
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) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandnn tank in pluce.)
❑ Installation ❑ Removal
Fuel OiL• gallons ❑ Underground ❑ Inside ❑Outside
LP Gas: gallons
Other:
GAS L1NE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
I, M�,`�) ��L �oW9f'0., Q-oDM
`� ��ST�(�-�, 2 Bf}'7� �1�'N S �OU/�l�-T ��JS �L• MA1 N '�E'�/E�' I�10 S ��!I�UJY�
PERMIT FEE CALCULATIONS
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum �e of$50.00)
�� x .0125 $ �Or
(contract pricc) (minimum$50.00)
2. STATESURCHARGE r,,
�c� x .0005 � -��
(contract pricc)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 5a•��
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged far 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 pennit 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 far issuance of a Mechanical Permit, agrees to do all
work in strict accardance with the ordinances of the City and the regulations of the State of
Minnesota, an ertifies all statements ade this appli 'on are complete,true and correct.
Applicant's � ature: Date: �' — �
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