HomeMy WebLinkAbout2012-00648 - mechanical CITY OF ORONO * Z 0 1 2 — 0 0 6 4 8 *
' 2750 KELLEY PARKWAY DATE ISSUED: 07/10/2012
ORONO, MN 55356-
' (952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1995 FOX RIDGE RD
PIN : 03-117-23-13-0005
LEGAL DESC : FOX RIDGE
: LOT 001 BLOCK 001
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : COOLING SYSTEMS
VALUATIOIY : $ 3,900.00
NOTE: 1 CARRIER 3 7'ON AC
APPLICANT MECHANICAL 50.00
CENTER POINT ENERGY MINNEGASCO STATE SURCHARGE MECH (VALUATION) 1.95
9320 EVERGREEN BLVD NW
SUITE B MAIL-[N FEE 2.00
COON RAPIDS, MN 55433 TOTAL 53.95
(763)757-6202
OWNER
KIELEY,THOMAS
1995 FOX RIDGE RD
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
'l�he work for which this permit is issued shall be performed according to
the approved 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 requires separatc
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
requested in conformance with the State Building Code.This permit may be
revoked at any timc for due cause.-
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Applicant Permitee Signature Date Issued By Si ature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
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FOR CITY USE OVLY
f �%''0"',� City of Orono
1' 4 � ti P.O.Box 66 Date Recei�ed: Permit#
�!�,,;,� �`�' 27�0 kelley Park�vay
�+ ��� i . F 1�I Cq�sral Bay,MN�5323 Approved By: Amount$:
�������u��'' Phone(953)249-4600 Fa�(9�'_)249-4616
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CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permiu must be approved by the Buildine Official or Inspector and/or Fire Marshall)
GENERAL INFORMATION
1. You ma}�apply for mechanical permits by mail or in person at the Ciry offices. Applications will
be reviewed and a permit will be issued within tw�o working days.
2. Permit cards will be sent by return mail after a review is completed. PER�IITS ARE NOT
VALID UTITIL YOU RECENE A PER�ti1IT. V�'ORti tiILST NOT BEGIN UNTIL THE
PER�ti1IT CARD IS POSTED ON THE JOB SITE.
3. I�lechanical Desi�ns—Complete caiculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air;.onditioning installation including
heat loss/heat gain calculation,design temperatures, equipment ratin�s and identification as to
type,manufacturer and model. Data shall be presented on form provided.
4. When any new construction or remodeling is involved,a separate buildin�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 final). Call(952)249-460C.
(2=4-48 hour notice required)
7. House Heating Test Record must be submit�ed before f.nal.
TYPE OF PERMIT
(Check All That A lv)
� Residential ❑ Commercial (Approval Required)
❑ '.�;ew ❑ Additional ❑ Repairs ❑ Replace
Job Site /Owner Inforrnation:
Site Address: �UX- � ��
r-----'
O�%ner: � M ��,g, .�� ?��lailinQ Address: ��� ��
c�ri: z�p: 5� L.=
Home Phone: � �c� � �g��c��lternate Phone:
Contractor Information:
CENTERPOINTENERGY JOANN ZINKEN
Contractor: Contact Person:
9320 EVERGREEN BL STE B 2201 3346
Address: State Bond#:
COON RAPIDS 55433 08/20/12
City: Zip: Expiration Date:
Phone: (763� 785-5404 Alternate Phone:
Travelers Indemnity Company
Workers Compensation&Employers Liability
❑ IIISUTariCe—CUt7erit: Policy#TC2K-UB_93496101
1 Policy Period Ol/Ol/2012-OS/Ol/2013
� �
MECHANICAL SYSTEMS BEING INSTALLED {
Note: All Geothermal Systems will now require a Site Plan&Review by our Buildin;Official.
IS THIS GEOTHERMAL? ❑ Yes �No
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SI'STENIS
Quantity: �
Make: ��t.��i.-�-Q
Model: f}'/�U�oc��
Tons: _��
H.Powec
FIREPLACES
❑ Gas Factory Fireplace Brand?�Tame:
❑ W'ood Burnina Fireplace
❑ Wood Stove � Ivlodel No.:
❑ Wood Stove with Flue/Masonry
�'EtiTILATION
❑ No. Kitchen Exhaust duct recirculating cfin
❑ No. Bath E�chaust(must have duct outside) cfin
❑ No. Other Fans: Locations cfm
FUEL STORAGE (�lus1 be approved by Fire Marshall if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
� LP Gas: eallons
Other: y
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
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PERMIT FEE CALCULATI0�1(Sl
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 service.
2. Has a total cost of$�00.00 or less;excludinQ the cost of the fixture or appliance: and
�. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip neYt section,if this applies; Cost of Permit $ 1�.00
State Surcharge $ �.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
i PERMIT FEE C ALCIJLATION(S)—JOBS OVER$SOC.00
If above does not apply;follow guidelines below:
1. CONTR4�T PRICE * is 1.��%of contract price with a(Minimum Fee of��0.00)
3°�G��D� X .oi2s� Sv • od
(cont;act pnce) (minimum 5�0.00)
2. STATE SL'RCH�RGE
� l� , a�.000� � �. 9�
(co�ct price)
�. POSTAGE R HA\TDLI'.�IG(On!y on A�1ail-In Applicationsl $ �.00
.�
4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) � .
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount cha;Qed for the
perrnitted work inclsding materiais, labor,profit, and other fixed costs. It is the amount to be chartred
to the customer for the work done. If any ma±erial, 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
es:imated cost er contract price for perrnit fee purposes. In the event that the;e is a dispute on the
amount of:he job cost, the City may request the submission of a si�ned copy of the actual contract.
MECHANICAL PERl�1IT APPLICATION AGREE�LENT
The undersi�ned hereby applies to the City for issuance of a Mechanical Permit, a�rees to do all
work in strict accordance with the ordinances of the City aad the regulations of the State of
Minnesota, and cenifies that all statements made on this application are complete, true and
correct.
Applicant's Si�nature: Date: � �Q/
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