HomeMy WebLinkAbout2005-P0896 - mechanical PERMIT
CITY OF ORONO
2750 K�Iley Parkway - PO Box 66 Permit Number: p08966
Crystal Bay, Minnesota 55323 Permit Type:
Mechanical Permits
(952) 249-4600 Date Issued:
7/18/2005
SITE ADDRESS: 1895 Fox Ridge Rd Unit#
Long Lake,MN 55356
P��� 03-117-23-13-0007
DESCRIPTION:
Proposcd Use: Residential
Permit Class: General
Permit Type:
Mechanical Permits Permit Sub-type(s): Multiple Mechanical Items
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Also Reconnect two furnaces to exisring main line
FEE SUMMARY: Permit Fee: $ 206.25 valuation: $ 16,500.00
State Surcharge Fee: $ 8.25
TOTAL FEE: $ 214.50
APPLICANT: Watertown Sheet Metal OWNER: Tobin&Mae Dayton
14730 Hwy 7 1895 Fox Ridge Rd
Mayer,MN 55360 Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPUANCE WITH ALL CITY OF ORONO ORDWANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
�,.�f�--� �� ����/� /
� APPLICAN'I'P6RMITEE SIGNATURE SUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
,�, Ju1-14-2005 12:35am Fram-CITY OF ORONO +g522494616 T-301 P.001/003 F-136
` , , ;FOIEt C�!'�!!;'1USE Y' '��
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� Cityoi"Orano QpcalRecctivc�r� ' !' Fe`mi2#t '
. Oji�' '�'O p.0,Hox 66 , , ,' '.'-r
2750 KeUey ParfcwaY '
, ` � Crystal Any�MN 553�3 !'+PProved By:�� �0}mt�
, ;:' �.,
����u� (952)249-a600
CYTY OF O1�20N0-1vIECH�NICAI..PLRMTT
(atl Conunercial pesmics must be approved by the Buildins Ofticiai or lnspecsor and�or F;rc Marshall)
�G�NER:A�="�-T�'a��4.TI0'�i' , ; ; ,. �
r the Ci offices. Applicauons will
erson
a
1. You may apply for mechanical pemzi�s by ma�l or in p �'
be reviewed and a pe�mit will be issued within two worldng days.
2, Pern�it cards wil.l ba sent by return mail after a revier�v is cornplcted. PERMITS A�.E N()T
VAT.rp UNT�I.,Y4U TtECETV�A pERMTT. WURK 1v[UST NOT BEGTN UNTYL TT�.�:
P�1�MIT CA.RY7 IS POST�D ON THE J' B SYTE.
3, Mechmnical Desiens--Complcte caleularions,details and specifications are requirefl far each
heating,ventiiarion,humidiCcation-dehumidificanon,and air conditioning installation including
heat lass/heat gain ealculacion,flesi�nn temperatures,equipmenz ratings and ideniificarion as to
ty�e,rnanuf'acturer and modei. laata shall be pxesented on form provided. e�T�ust be
4. When any new consmxcaon or remodcling is involved,a separatc building p
obtained.
5. 1i11 work must be done in aecordance wi'�h thc'(3niform Mechaxucal C�de/Srate Building Code
requiremenCs,
6. All work must be inspected(rougb-in and fmal)• Call{952)249-4b00.
(24-48 hour notiee requfred)
7. House Heating Test R-�cord must be submitted before final.
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; �
�Residenual ❑C4mmercial(Approval Required)
Q New �Addirional ❑Repairs �Replace
'3ot�`,Slte Y;Ouviier.;T�'�Q�rniafi�on:' � ,
c'd �S� �p �' ` �_ ���
Site Address: 1 � Q
J�y a1t/ Mailing Address: / 9 � �Q ' ���1 ���
Qwncr:�_ �,��"t
City: � o n� /•G ,�'r zip:
T�ome phone; Alternate T'hone:
; Cbntra�cCar�ifonnation: �r � , � :, ;' �;� ;
c ��f� 1 , �,��
o u> J�F�conr�ct perSQn: �/w, n/ �� �
Cantractor: �rg��� �
Address: �� �� � N�'�' � State Bond#: �� 7 S��
, � ��C.� U o � 5 0 �
City: �'�� � 2 zip:s�' Expiration Date: l
Phone� �J� c�- �� �a�s/7 Alternate Fhone: �5r� � � ��� I
❑ Insura.nce-Current: �/' � �
1
�7-14-20�5 ��:33 WATERTOWN SHEET METAL 952 657 2553 PAGE: 1
,� Ju1-14-2005 12:35pm From-CITY OF ORONO +g622494616 T-301 P.002/003 F-136
r1 q/ 'i�'� <� ,�.,;r�, � � '�1',�,� '• ��ti� �, ��: ' ��r.:f,���i� ��sj�`;.'�'�cl���"h,+�;�r���l��rl��d��:'�.`
���,���h-����'<f.�,��4} �I�'I��F�i)��f�t�.'b��� �H �Jl I,�'h"t����.
�:7'.
HEp'r'Y1�iG SYST�MS
QtlanTit�: �
L�!�/t .�� �-�h r o k
Make� '-5 Dclfi-- 36 j-O g D
(� fv ✓�a ���G-�=�9�EX�'S�'-'-�
Model: r � � ---"—
�,,,e�:
�T (�-As �1/�T
a r, �,�, v�,��- � � r��� r- �.������
Fluz Size: U�—
�p�.�sTvs:
g �o 0 8 �oo
� p d ���O D
Qu�put�TUS:
c�M: (�v a -1 3`�5� ,i�o--/g o0
COOLTNG SYST�MS
Quantity:
Makz: ��/���,�. �--�/�lri
Model: /�^/'.�/-S' D,S D /�S�' = �.3�
Tans: ..—
� �
/
H.Power _—��' ���
�'I1�PLAC�S
[] Gas Facrory�'ircplace
� � p Wood IItuning Fizeplacc
� V�,rood Stove
Wood Stove�7ith Flue
Brand Name: Modet No.:
VE_ NTII ATION
[] No- Kitchen�xhaust_„_�„_,
duct recirculating ��
.� No _� - gath�xlzaust(musc have duct outside) ��f�
� No_ Qther�ans� LocAtians
�'I3ET.STORAGE (MUST BE APFIZOV'�A BY F7RE Iv�,ARSHAT.,L)
�] I,nstalla�ion ❑ Removal
N ; Aua� ❑ Undergrouud ❑�side ❑Ou�side
� �ucl(Jil: g
I L,P Gas: �_„�allons
t Qthez�
GAfi LYNE ONLY
�/?/7 �< l,v0
� �utdoor C"xri21 f� C3iher/�ist W'hat&Wh�xe: �' .�
��-f�MI���S
2 �b �X,'s�'��G�
� /y/A,'i't /�"n �
07-14-2�@5 00:33 WATERTOWhJ SHEET METAL 952 657 2553 PA�aE:2
4 Ju1-14-2005 12:35pm From-CITY OF ORONO +9522494616 T-301 P.003/003 F-136
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� �e �R 'v ,al�� �J+ a ?���.Mf`�;' '��fG,c'�. '�" � i� Y yt ���w' ' �d � �� ��ll!','r i �4 1� �,1��' !��t{pri� ��:r�i�� ���1 U
��'Y�fi;.�� ��i c,. �� � I 6 � � '�' ��: �1 it f'h����,i �f } c i �It,'> '�i�r r if + ��o�ft�q �r�4 �Jdi L) x^ �^'174i��:�
yn�� 1 ri � � 1� JI' 1 �(j(+i�, �7��M'',�^r�'7i��tt � ,�,�F �}�![7 I,� f I l; I L I �� G ti �
�d� 1 c�f r ��'l�� i�f'� �j���li',J�{�?-24?`('ti'��'7+1��.�..
�r"� i� I �i)�.i � f�9 ��i J ( Y'!�'�� t ��I;����,..
r�rrt.�;i�h;f �,�'N1 rrp 1�r r t ti l�� ir�p�;n',`'"��t.�l`a,�,'i.� � c...���„I.lft� ,�h ,i .Y,,,,,.,ua,, .,r�•.,�i;IF..,
�r.�;�11•'_'a� �,�t ��ll��<<a�rdr7.,��rtt�,,i�li,(F�I) �,t P t A,�s
� Yes,this szction applies
Tue replacement of a siden � 1 fixturc or a �ance tha�meets all three of the following requirernenu:
�, po, e�not xec�uire modif'iea�Yon eo elactrieat or gas service.
2, Has a ta cost of�500.00 ar less; xcludin the aosc of the fixture ox appliance, and
3. Ts improved,iuscalled or replaced by the homeowncT ox licensed con�zActoY,
Cosr o�'PeiTnit $- �j'��
Skip next seerion,if�iis applies; S�tie Surchargc �—��
Mail-In k'ee(Zf Applicable) ����
Total permit�'ee S.—�-�-
n,(� � � �,°��� �a r,.:r�,��. ��,r.
,r �� , ��;�,,I� 1v��� ��� (�I�1 ����k"`'+,'�.���r�;�''�t%:�w::��::��,
i�, I ' ��4�L$ r r 1 j'T,;�:r'kl'+rl�i1,,I t���'�, . �� �J�ir'Y.��,. .,..?�'..�, i, �;��.V,Xxti'l� ���.,;..� r:
.,�r •b..0.fl�r: �h� c. .I)ri�' .��'•
If above does noz apply;follow guidetincs below:
1. CONTRACT PRIC� "` is 1.25%of contract price with a(Minimum�'ee of:��'0�J�
i �j
/�(Tj x.o125$ v'��
(c n�M���) (minimum�35.00)
2. STA'I'�SURC�►R�'� **Add rhe State Bldg Code Div.Surcharse(Minimum Fee of$.50)
/(Q (�Q, � x,0045 $ � ` ���
on�racc prict) (minimum$ .50)
$
3. POSTAGB&HANULIN�r(Only on Mail-In Applications) �
4. T4'�'AI..PERMIT FEE(
Add�.i,nes 1-3 Abovc) �_��� �O
� "' CONTRACT P�C� ar�iB��abor,�profi�And other fixed cosu.a t is the�amount t�ogl>e hoarg d
per�n�rted work including
to the cusromer for the work done. If snY mat�xial, equipment, labor or installacions are ftiunis}�e Y
thc awner, tananc or �co��ce for permit fe�pu�P�����n the evanzCthat bere us a d'�spu e on tbc
estimated cost or con p
amount of che job cost, the City may request the subritission of a signed capy of the actua contrac .
• '�"�'Tbe STA,'�'�SURC�ARG�is .0005 of rbe Building DeParantni at(952)249�4600 for the price.
i t T �.1� 1: 1���� ;t���4�,f���i;t
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q' ;.5! a. 'I �WJ-k�.'�','r; '
FP Ill�t 'r
T'he undersi�ned hereby applies tl7e�xd"manc�esi f the C�ty andcthe regulations o�the State of
wprk in stricc accordancc vv�th
M�nesota, and certifies that al] statements xnade on this applicatian are complete, true and
cOrreCt_
' /'J �_`�
, Date:
Applicant's Si�nature:� �'""—'
3
�7-14-2��5 ��:33 WATERTOWN SHEET METAL "�52 657 2553 PAGE:3
�INf nesota!
Building Codes and Standard Division
Commissioner of Administration
Has Received and Filed a 525,000 Surety Bnnd,
As Required by MS 326.992,for VVork Regulated
by the State Mechanical Code
TO• Elwin Bauer Rond No: 69795545
. Watertown Sheet Metal,Inc. MB ID: 00689
Effective Date Expiration Date
10/26/2004 10/25/2005 -
� !
�4C4Rt�, ��RTIFIGAT� C�F LIABIL,ITY INSUf�ANCE 07/14/20Q5'
. PRODUCER (gs�)448-3800 FAX (9S2)4�i8-3304 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Gasual ty Assurance Inc ONLY AND GON�ERS NO RIGHTS UPON THE C�RTIFICATE
HOLDER.TMIS CERTIFICATE DOES NpT AMEND,EXTEND OR
101 West Thi rd Street ALTER THE COYERAG�AFFORDED BY'THE POLICIES BELOW.
PO Bax 38 . �
ChdSka, N0V 55318 INSURERS AFFORDING CQVERAGE NAIC l!
iNsuaEo Watertown Sheet Metal �NeuRERn: Ineegrity Mutual Insurance Co _.
I�FT3O N� 7 WSLIR[RB: __
Mayer, MN 55364 �NsuReRc: _
INSUR[R D:
IN.4tJRER 6:
COVERAGES •
TH�P4lIC1ES OF INSURANCE IISTED 6ELOW HAVE REEN ISSUED TO 7HE INSURED NAMED ABOVL-"fOR THE POLICY PERIOD INPICATED.NQTWITNSTANDIIVG
ANY REQUIREMENT,TERM OR CONDI'TtON OF ANY COh1T'RACT OR OTHER DOCUMENT 41fl7H RESPECT TO WHICH THIS CERTIF�CATE MAY B�ISSUED OR
MAY PERTAIN,Ttt�IPISUR/+NCE AFFORDED BY 7HE PQLICIES DESCRII3ED HEREIN IS SUBJECT TO AL�THE TERMS,EXCLUSIONS AND CdNDITIVNS OF SUCH
POL{CIES.AGGREGATE LIMITS SNO�NN NIAY HAVE BHEN REPUGED 8Y PA�D CIAIMS. .
1 R Off TypE QF INSURANCE POLICY NUMBER ��Y�FECTIVE POLICY 6 IRATtQN LIMITS
cErrer�a�unsnm ��� � 950903 09/30/20Q�4 Q4/30/2005 CACM OCCURRENCE a l,00U,4�4
X COMMERS:IAL GFNSRN.LIAOIUTY I'�AMACE TO R[NTED S SO�OO�
R.FMISES{
�GAIMS MMF a OCCUR MCO EXF'(AnV ona(urso�+) r 5,Q(I()
A PCRSONAL&AOV INJURY E 1 QdQ s(3(IO
— �� (;GNCRAI ACCRtC+ATF S Z UO(j�OOO
CENL AGGRfi6ATC LiMIT APPLI£S FEP' YfiO�TS•COMPIOP At3G i Z,d0���Qt}
PCJUCY l '�E�-�7 n lOC
auro�oai�e uneairv 9509Q3 09/3U/2004 09/30/20Q5 COM91NtU S�NGLE LIMIT
tea axineml S 1,000 OQO
J( ANY AUTp ,. _
ALL UNME�AUTOS Bpp1LY INJUFtY L
SCHEDULEO AUTO.S (Per pereonj _
A -
x 1 IIRCD AUTUS �ODtLY INJURY s
X NONOWNEOAUIOS t�r���) _..
FAOP�RTY DAMAGE &
. {Pqr accidm�ty
. .. .GARAGE UAB1LtTY ^ .. . . � v AUTO ONIY-FA ACCIDChT 3 -
ANY AUTO Ul'MtFt 1'HAN �ACC S
AUTOONLY: AGG S
_.... ._.. . .
EXGE$S�UMBRELLAUABIUTY 950903 09/30/200� �5�3��Z��S EACHOCCURhttNCF. 5
}� nCCUR �CINAdS MADG AGC'REGAT[ . S I,iUOU�O�Q
A .. a. •
�EDUCTIBtE '
RETCNTION E a
wowcERscoMPensAraNnNo 950903 p9/30J2004 09/30/2405 X RviMl�s. `�r`�_ . _.
EMPLOYER9'LIABILITY E.L.FACH ACC,If7ENT 3 SO{I OUO
A ANY PROPRIETUHIPARTNER/GXCCUTIVE "'
OF!'ICERIMEMBtfi FXf;I.t1DE07 E.L.U18t0.SF_Fl�EMPLOYE S SOO OO
ir g�x,��;��naer e.�.aSeaSE.atxicv i�r�ir s 500 OOq
SPECIAL f ROV�SIf1NS qalow ., . . ..
qTNER
DESCRIPTION OF OPERATIONS!LOCATIQNS!VEXICLES 1 EXCLUSIONS AOOEO BY ENDOR9EMEfiT 1 S
� r.
CFF�TIFICATE HOLDER c ----
fiHOtiLD ANY OF THE A80YE GE5GR�8ED POLICIES BE CRNCEl4E0 BEPORH THE
EXPIRATION DATE THEREOF,'YHE t6&UING INSURER WILI.ENOEAVOR TO MAII
3O DAYS WRI7TEN NOY1C&TO THE CERTIFICATE HOU7LR NAMED TO THE LEfT,
Gi ty of Orono BUT FAILURE TO MAIL SUCN NOTtCE SNALL IMP09E NO O�UGATION OR LIABILITY
PO BOX E� OF ANY KIND UPON TNE INSURER,ITS AGENT9 OR R8PAE8ENTATIVE3.
Crystal 6�y, MN 55323 AUTNORIZEUREPRE9ENTAl1V� ;Y'�1��+."1�.�;y}�<<;�;�``
Jene Smith ]MS
ACGRD 2S{2oo�ros� 4ACORD CORPORATION 1968
�7-14-20�5 �2:40 WRTERTQWN SHEET METAL �52 657 2553 PAGE:1