HomeMy WebLinkAbout2005-P08921 - gas line inspection PERMIT
CITY �"JF ORONO
275�Kelley Parkway- PO Box 66 Permit Number: p08921
Crystal Bay, Minnesota 55323 Permit Type:
Mechanical Permits
(952) 2�9-4600 Date Issued: 7/6/2005
SITE ADDRESS: 1895 Fox Ridge Rd Unit#
Long Lake, MN 55356
PID: 03-117-23-13-0007
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Mechanical Permits Permit Sub-type(s): Gas Line Inspection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Install gas line only for stove&gas dryer
FEE SUMMARY: Permit Fee: $ 35.00 valuation: $ 1,000.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Johnson Plumbing and Heating Co. OWNER: Tobin&Mae Dayton
7145 Oakland Avenue South 1895 Fox Ridge Rd
Richfield,MN 55423 Long Lake NIN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLIC NT PERMITEE SIGNATURE SliED BY SIGNATURE
Copies: 1-File(SignaturesRequired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, 1-Septic) Page I
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FOR CITY USE ONLY
j ,���, City of Orono
P.O.Box 66 Date Received: Permit#
/ ��:;::,,,,, � 2750 Kelley Park�vay
a ,�j�'?�;���. �. Crystal Bay,MN 55323 Approved By: Amount$:
� '��*y�`+'��.o` (952)249-4G00
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CITY OF ORONO -MECHANICAL PERMIT
(All Conunercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical pernuts by mail or in person at the City offices. Applications will
be reviewed and a peinut will be issued within two working days.
2. Peinut cards will be sent by retuin mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTTL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
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 temperahu•es, equipment ratings and identification as to
type,manufacturer and model. Data shail be preseuted on form provided.
4. When any new construction or remodeling is involved, a separate building pernut must be
obtau7ed.
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 subinitted before final.
TYPE OF PERMIT
(Check All That Apply
�]C Residential ❑ Coirnnercial(Approval Required)
❑ New ❑ Additional ❑ Repairs ❑Replace
Job Site/ Owner Information:
Site Address: �� 5,}' /�p h ��c�r� 2�)
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Owner: _ O;(3T ,(7�7� Mailing Address: S '
City: L o�b (.-�<<L Zip: c1�S'� �S�
Home Phone: Alternate Phone:
Contractor Information:
Contractor: ��C�f�^�S�"�� ��(�r/c/�� Contact Person: ����
Address: `7/�f;f" (j�/�Lf��� r'1c.� State Bond#: d/,�S��, %6 fl��
City: �Z�c,��< < (�� /'�`"f Zip��yz� Expiration Date: /L�,�j�oJ'
Phone: C �Z- Z�j �3 S�,f� Alteinate Phone: G/?� c5��S�".�}Q ��
❑ Insurance- Cun-ent: /�C-���?�
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MECHANICAL SYSTEMS BE1NG INSTALLED
, ` .
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
❑ Wood Buming Fireplace
❑ Wood Stove
❑ Wood Stove With Flue
Brand Name: Model No.:
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)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill �-- Other/List What&Where:cS�d�L (��.f ��P2
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� � PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all tluee of the following requirements:
1. Does not require modification to elech�ical or gas service.
2. Has a total cost of$500.00 or less; exchidin�the cost of the fixture or appliance: and
3. Is improved, installed or replaced by the homeowner or licensed conh-actar.
Skip next section, if this applies; Cost of Pernut $ 1�.00
State Surcharge $ .50
Mail-Ii7 Fee(If Applicable) $ 1.50
Total Permit Fee $
PERMIT FEE CALCULATION(S) -JOBS OVER $500.00
If above does not apply; follow guidelines below:
1. CONTRACT PRICE * is 1.25%of conhact price with a(Minimum Fee of$35.00)
f oo Q . p o X.oi2s �
(contract price) (minimum S35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLIIvTG(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Liiles 1-3 Above) $
• * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
pemutted 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 materiai, 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 pernut fee puiposes. 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.
■ **The STATE SURCHARGE is .0005 of the Building Department at(952)249-4600 for tl�e price.
MECHA1vICAL PERMIT APPLICATION AGREEMENT
The tmdel-signed hereby applies to the Ciry for issuance of a Mechanical Pernlit, 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 this application are complete, true and
correct.
Applicant's Signature: !l Date: 7 � 0
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