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Home My WebLink About2012-00784 - mechanical T • CITY OF ORONO * z 0 1 z - 0 0 7 8 4 * 2750 KELLEY PARKWAY DATE ISSUED: 08/14/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 915 FOREST ARMS LA PIN : 07-117-23-12-0018 LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN : LOT 001 BLOCK 002 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES- MULTIPLE VALUATION : $ 6,000.00 NOTE: (1)BRYANT HGATING SYSTEM MODEL-386TA-NATURAL GAS-2"PVC-8Q000 INPUT,78,000 OUTPUT B"I�U'S- 1600 CFMS (10 BRYANT COOLING SYSTEM-MODGL- 126BNn-2.5"I ONS-25 AMP APPLICANT MECHAN[CAL 75.00 COUNTRYSIDE HEATING& COOLING STATE SURCHARGE MECH(VALUATION) 3.00 6511 HWY 12 MAPLE PLA[N, MN 55359 TOTAL 78.00 (763)479-1600 PAID WITH CC# 1067 OWNER BELAWSKI&AARON RUSS,JAMIE 915 FOREST ARMS LA MOUND, MN 55364 AGREEMENT AND SWORN STATEMENT l hc work for which this permit is issucd shall be performcd according to thc approvcd plans and specifications,applicable 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 rcquires separate permits. All provisions of laws 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 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 requeste in conformance with the Statc[3uilding Code.This permit may be revoke �t any tim f e cause. � � � � � �l /`�7 �a� Applicant Permitce Signature Date Issu By Signalure Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE. From:COUNTRYSIDE HEATING & COOLING 763 479 2518 08/13/2012 11 :43 #572 P.001 /003 � � F �USE ONLY '0�� City of Orono p �a¢ �� P.O.Box 66 Date Receivod: �3 � Pecmit#�� CJ � j� y�,,, 1 2750 Kelley Parkway �,� /�-� �� ;�,;:. /� Crystal Bay,MN 55323 Approved8y: Amount S:[�_ �• 1��\��.�j� Phone(952)249-4600 Fax(952)249-46I6 ' �,,.__�� G�� CITY OF ORONO—MECHANICAL PERMIT (All Commercia]pecmits must be approved by the Building Official or Inspector and/or Fire MarshallJ GENERAL INFORMATION 1. You may appiy for mechanical permits by mail or in person at the City offices. Applications will be reviewed and a permit wil]be issued within two working days. 2. Peirnit cazds will be sent by retum mail aftcr a review is complctcd. PERMITS ARE NOT VAT.I17 UNTIL YOU RECEIVE A PERMI"I'. WO��MUST NOT BEGIN UNT1L TI3E PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desiens—Complete calculations,details and specifications are required for each heating,vontilation,humidification-dehumidification,and air conditioning installation including heat loss/heat gain calculation,design temperatures,equipment ratings and identiftcation 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 inspccted(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 ❑Commcrcial(Approval Required) ❑ New ❑Additional ❑Repairs ❑Replace Job Site/Owner Information: Site Address: .9�� '-�� m �a� � Owner: �7`�'a r0 h i�,u S� Mailing Address: 9�.� �'"�'-�d Gyt�'w� ��'1 c�ri: Oro►-�o z�p: ,3'�^3 5.6 Home Phone��7- 96�8 Alternate Phone: Contractor Information: Contractor: (� S��Q 5�� Contact Person: � rlQr LPi✓�i�li1 ��e �� Address: �`.��(� W �� State Bond#: I�f lJ �� _ City: jl�� ? �I�� Zip:��35,�Expiration Date: 6 �O °�'�/ Phone: �76.�1�.7�'�6�/� Alternate Phone: � ❑ Insurance—Current: /►'Vv►� « ��'� 1 ��jV�u(�-� F,rom:COUNTRYSIDE HEATING & COOLING 763 479 2518 08/13/2012 11 :44 #572 P.002/003 . � ' . : :I1�IECHANICAi.,SYSTEMS BEING.=Ti�iSTAI�LED : , .._ ;: ; . : Note: Atl Geothermal Systems will now require a Site Plan& Review by our Building Official. 1S THIS GEOTHERMAL? ❑ Yes �No HEATING SYSTEMS Quantity: � Make: Model: a!�� - Fuel: ___�__C� Flue Size: p9,,�1 �V� Input BTUs: � U �� _ Output ST[Is: �� _. CFM: � C O _._ _. COOLING SYSTEMS Quantity: y __. _ IV1ake: Model: �O��o B�Y'�• Tons: Ol ' � 1-�.Power oC..�M p FIREPLACES ❑ Gas Factory Fireplace Brand Name: ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTIL,ATION ❑ No. Kitchen Exhaust duct recirculating cfrn ❑ No. Bath Exhaust(must have duct outsidc) ,cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (Must be approved by Fire Marshall if propnsing to abando�i tank rn plac�) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside LP Gas: gallons Othcr: GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List Whai&Where:__ 2 From:COUNTRYSIDE HEATING & COOLING 763 479 2518 08/13/2012 11 :44 #572 P.003/003 . , , ., .. , . � .: � �ERMIT�FEE CALCULAT�ON{�) ��= �-,- � �= � �:: ' BASED OFF-2002 STATE STATUE ❑ Yes,this section applies The replacement of a Residential fixture or a�pliance 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;excludinQ the cost of the fixture or appliance:and 3. Is improved,installed or replaced by the homeowner or licensed contractor. Skip next scction,if this applies; Cost of Permit $ 15_00 State Suzcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee S .... . 9:�.F. ..,.....:.. ....��.�... . ..�.��:"1�,�,�alr.i77:�+Yx��,1.^.1 �� ::?'.��17�.�V�F'��.Y�.k�D .�...;,#X �,�..,h�)!4 s,..n�,u If above does not apply;fo(low guidelines below: 1. CONTRACT PRICE *is l.25%of contract price with a(Minimum Fee of 550.00) 600D. � X .o�2s$ �3' 0� (con�act price) (minlmum 550.00) 2. STATE SURCFiARGE 6 0 00 _ oo _x.0005 $ ,� (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2�0 ____! 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ / $ , 0� ■ * CONTRACT PRIC� or JOB COST means the actual or estimated dol[ar 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. Tf any material, equipment, labor or installations aze furnished by thc owner, tcnant 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 amounc of the job cost, the City may request the submission of a signed copy of the actual contract. , �C�I�IC�I�,�P�IZ��'�'�-��,.�`r��`$'�4I!�,�'+.��`r�Ei1+�E.N�`_ ' .� ��:.� � . 5 -ti_�,4'.. , itM'}S9 h na'Fi 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 State of Minnesota, and certifes that all statements made on this application are complete, true and correct. Applicant's Signature: )� ✓ Date: � ��'�J ' �� 63 .y�g , troo `Reset Fotr�i � ,..,,-..... . . ...- ,..,r.��.( 3 � �� C�� D TE TIM� CITY OF OROIVV CALLED IN � �/�e�� INSPECTION NOTICE ,�CHEDULED �� PERMIT NO. � —��7�r"cOMPLETED ADDRESS `-� OWNER S TELEPNONE N .�D��J—.�`7��'�fI� CONTRACTOR >; DESCRIPTION i��'2�'�Q� ry /� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PIUMBING RI ❑ SEPT FINAL ❑ FOUNDATION/REMOVAL Z O TRACTOR TO MEET YOU:�1(ES_NO � OC MMENTS: � W a � J O � � O � W � Q � Z W � W � � � GW ❑WORK SATISFACTORY:PROCEED �-PFIOJECT COMPLETE � ❑CORRECT WORK&PROCEED 1- ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46QQ OwnerlContractor on ite: Inspector. White Copyllnspector's File Canary CopylSite Notice