HomeMy WebLinkAbout1994-006063 - ac PE�ZI��IT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 ���� S::i=::f�:;w:�`i_
Orono, Minnesota 55356-0815 Permit Number: - = -� .- ..
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(612) 473-7357 Date Issued: : - " �" "
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REMARKS:
FEE SUMMARY:
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PP�IC TiPERMITEE SIGN RE ISSUED BY:SIGNATURE
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CITY OF ORONO APPLICATION FOR MECHAIVICAL PERNIIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be
reviewed and a pemut will be issued within 2 working days.
2. Permit cards will be sent by retum 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 Designs - Complete calculations, details and specifications aze 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. Ideatification of and specifications for water heating equipment
shall also be 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 finai). Call 473-7357. 24-hour notice required.
7. House Heating Test Record must be submitted before final.
Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification.
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 473-7357.
Please check one: New Addition Repair Replace
Residential Commercial
JOB SITE: g�S �=o r s-�-�r vvi5 �--l�l Zip: 5 S 3(o`-�
Owner's Name: qr✓� i�e. Cq.�ls� �. _Telephone Number: �(�Z-�f �`� �
Mailing Address: sa v��-- City: 0�6 v�o ZiP� SS3 e�-�
Contractor'sName: Ca�,,w-���,,����- �t-q � t-C�-q , TelephoneNumber: �-(��- L Z�r'�-r
MailingAddress: l o$�o co. IQ� • 2 o City: Q�ow�.e Zip: �5�Z�
SYSTEM DESCRIPTION
HEATING SYSTEMS
Quantiry:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantiry: �
Make: Ca,r r') e c'
Model: ?nT�7-T d3�
Tons: Z�� Z.
H. Power
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WOOD BURNING EQUIPMENT
Wood stove with flue
Wood combination or add-on
Factory fireplace with flue
Factory Fireplace (s) Freestanding Masonry
Wood Stove (s) Franklin, other
Brand Name Model No.
Mfgr's Min., Clearances, side , rear , min. flue dia.
Total
VENTILATION
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. Other Fans: Locations cfm
Total
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation Removal
Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or 1VV�inimum Fee ($35.00)
i��-� a� y��� x;,0125 $
(contract price)
2. State Surcharge. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $
(contract price)
or $.50, whichever is greater
3. Posta�e and HandlinQ (Only mail-in applications) $ 1.50
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. It is the amount to be charged to the
customer for the work done. If any material, equipment, labor, or installation 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 pemut 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 of the contract price under $1,000,000 or $.50 - whichever is
greater. For valuations over $1,000,000 call the Department of Inspectional Services for the price.
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 City and the regulations of the Minnesota
State Building Code, and certifies that all statements made on this application are complete, true
and correct. �
Applicant's Signature: � Date: -�'� - �1 �
Approved By: Date: