HomeMy WebLinkAbout2011-00232 - mechanical CITY OF ORONO PERMIT NO.: 201�-00232
� 2750 KELLEY PARKWAY
l ORONO, MN 55356- DATE �ssUED: 04/2U2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 895 FOREST ARMS LA
PIN : 07-117-23-12-0015
LEGAL DESC : FOREST ARMS
: LOT 007 BLOCK 002
PERMIT TYPE : MECHANICAL(> $500)
PROPERTY TYPE : RESIDENT[AL
COI�STRUCTION TYPE : MECHANICAL- MULTIPLE
VALUATION : $ 8,500.00
NOTE: 1 CARR[GR NAT. GAS FURNACL;
1 CARRIER2.�I�ON AC
I
�
APPLICANT
KATH HVAC MECHAN[CAL 106.25
3096 RICE STREET STATE SURCHARGE MECH (VALUATION) 4.25
LITTLE CANADA, MN 551 I�- MAIL-[N FEE 2J5
(6�1)484-3326 MISC FEE 0.00
TOTAI. I 13.25
OWNER
O'BRIEN, JOHN &CONNIE
895 FOREST ARMS LA
MOUND, MN 55364
ACREEMENT AND SWORN STATEMENT
l�hc���urk for which this permit is issued shall be perturmcd accor�ing to
the approved plans and specifications,applicable Ciry approvals.�nd the
State I3uilding Code. "fhis permit is for only the work described and does
no[arant permission for additional or related work�vhich requires scparate
pennits. All provisions of la�vs 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 aulhorized is not
commenced within I SO days of the date of issuance,or if construction is
� suspended for a period of 180 days at any time aftcr�vork has commenced.
l�he applicant is responsible for assuring all required inspections are
requcsted in conformance with die State I3uilding Code.This pcnnit may be
revoked at any timc for due cause.
\;�1'1-�- �� / / / /
� npplicant Permitce Signature Date Issued By Sigi re at�
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOU
. �
,
'� FOR CITY USE ONLY
� ,�`�'� City of Orono i�
�J � P.O.Box 66 �7ate Received: Permit k
� '�:, ��� 2750 Kelley Padcway '�
i�`� �}�� h�,J Crystal Bay,MN 55323 �pproved By: Amount$:
\���;ty�,�r.�ofij Phone(952)249-4600 Fax(952)249-4616
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CITY OF ORONO—MECHANI�AL PERMIT
(All Commerciai permits mus[be approvcd by the Building Official or Inspcctor and/or Firc Ma�shall)
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 worlc�ng 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 IYIUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE
3. Mechanical Desiens—Complete calcutations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air conditioning installation including
heat loss/he�t bain ca1�U�3UCS?,design tem�era±�res,eqe:ipmer.;rat�ngs and iclentific�tion as te
type,manufacturer and model. Data shall be presented o�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 IVlechanical Code/State Building Code
requirements.
6. All work must be inspected(rough-in and 6na1). Call(9$2)249-4600.
(Z4-48 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)
❑ New ❑ Additional ❑ RepairS Replace
Job Site/Owner Information:
Site Address: ����
Owner: Mailing t�ddress: D � ��/�/1'!'�.5� •
�.��: Z��: 55.��
Home Phone: /��•�/�Q•��d U Alternate �hone: /J� ' �'�' ���i�.
Contractor Information:
Contractor: ,����Z(.�/C� Contact P�rson: � � %Qm.s
Address: t;�o9� �_��• State Bond#: � �,•
/ �
City: t� C.,C(/1�[GG�J'�J'r/��Expiration�Date: O /�� �
Phone: t7J�,��•,�,'p� Alternate �'hone: ��� '7� ' G �j
_
❑ Insurance-�Current: C e1��DS,L�,.
1
, �
' ° ' ::�MECH�NI�`� '`S��'STEIvIS:BEIN�TNSTALLED"'
Note: All Geothermal Systems will now req 're a Site Plan & Review by our Building Official.
IS THIS GEOTHERMAL? ❑ Yes [�No
HEATING SYSTEMS
Quantity:
Make:
Model: _�`�LLCI.Y�LlC! �// �
Fuel: . , Q;�
d
Flue Size:
Input BTUs: QrJQ
Output BTUs: �J �0 _
�-
.
CFM:
COOLING SYSTEMS
Quantity: / �
Make: :
Model: .,J�JU
Tons: ���
H.Power �/J '
FIREPLACES /
❑ actory Fireplace Brand Name:
❑ Wood ing Fireplace
❑ Wood tove Model No.:
❑ Woo Stove wit ue/Masonry
i'ENi;LATiON
❑ No. Kitchen Exhaust duct�; recirculating cfm
❑ No. ath Exhaust(must have duct ou4side) cfm
❑ No. Ot ans: Locations cfm
FUEL STORAGE (M , be approve y Fire Marsha[1 ifpropdsing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: � �allons ❑ ;Underground ❑ Inside ❑Outside
LP Gas: ga4 ons ;
Other.
GAS LINE ONLY
❑ Outdoor ill Other/List What&Where:
2
��d��'r. PERMIT FEE CALCULATION(S) `"��'���
BASED OFF-2002 STATE'STATUE
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1. Does not require modification to electrical or gas seivice.
2. Has a total cost of$500.00 or less;excludine the co$t of the fixture or appliance:and
3. Is improved, installed or replaced by the homeownet or licensed contractor.
Skip next section, if this applies; Cost of Permit $ 15.00
State Surch�rge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
'fotal Pert�tit Fee $
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�° �'ERMTT F� � r R... 4�;{� ,.��A����°-�� ���.
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If above does not apply; follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
. ' ��C/V. Pl/ x .0125 $ /O((J� 0�.7
(contract pricc) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee ofS5.00)
✓4C/, 'v ' x.0005 $ �./• �
(contract pricc) (minimum$5.00)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines I-3 Above) $ / 3.�7'�
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials,labor,profit,and other fi�ced costs. It is the amount to be charged
to the customer for the work done. If any material, equipme�t, labor or installations are fumished 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. Ir� the event that there is a dispute on the
amount of the jab cost, ihe i,iry rnay reyuest the sucn.ission of a signe6 cupy of tne actual contract.
• **The STATE SURCHARGE is .0005 times the Contract Prr.ce or a minimum of$5.00.
' • � , MECHANICAL PERMIT APPLICATI�N AGREENIEN� rfs'; .�� ...
The undersigned hereby applies to the City for issuance of� 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 thi5 application are complete, true and
correct.
Applicant's Signature: ' Date: r����
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