HomeMy WebLinkAbout1994-005972 - gas line PERMIT
C�TY OF ORONO PERMIT TYPE: : - .-_: ::.::: r.:..:
' 2750 Kelley Parkway • P.O. Box 815 Permit Number: ��it�;,��,�:�'z��;��s-��'-�
Orono, Minnesota 55356-0815 " " - - .�4-.
(612) 473-7357 Date Issued: k-;�;;%��,:;.;°=�.
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APPLICANTiPERMITEE SIGNATURE ISSUED BY:SIGNATURE, '����
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CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
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 2 working days.
2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Mechanical DesiQns - Complete calculations, details and specifications are required for each heating,
ventilation,humidification-dehumidification, and air conditioning installation including heat loss/heat gain
calculation, design temperatures, equipment ratings and identification as to type, manufacturer and model.
Data shall be presented on form provided. Identification of and specifications for water heating equipment
shall a?so be providPd.
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 inspected (rough-in and final). Call 473-7357. 24-hour notice required.
7. House Heating Test Record must be submitted before final.
Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification.
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 473-7357.
Please check one: New � Addition Repair Replace
Residential Commercial
� � . Zip: �>�� 5c�`/
JOB SITE: ��,y Q �--t�c ��
Owner's Name• �N,,,�U l�o�- �m� Telephone Number: y ) y - 3��`���
Mailing Address: , /z City:�' �- ,-z-<<� Zip: `�, "3� `/
Contractor'sName: -r�c�� �--u��_� �- �1 �,�ti� � Teleph9neNumber: �%:�� r ,�-�3 �-
MaiGng Address: ��i ;� ; ��Q, .�i�.�, !,)�- City: /�,<<: �� �, Zip: ��� 3 7�/
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SYSTEM DESCRIPTION
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H. Power
� 1
WOOD BURNING EQUIPMENT %i�
Wood stove with flue ��"
Wood combination or add-on �
Factory fireplace with flue
Factory Fireplace (s) Freestanding Masonry
Wood Stove (s) Franklin, other
Brand Name Model No.
Mfgr's Min., Clearances, side , rear , min. flue dia.
Total �C1n`�
VENTII,ATION
No. Kitchen Exhaust ducted recirculating cfm
N�. Bath Exhaust (must be ducted outside) cfm
No. Other Fans: Locations cfm
Total
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation Removal
Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
x .0125 $
(contract price)
2. State Surcharge. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $
(contract price)
or $.50, whichever is greater
3. Postage and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $
* ^CN�4t.�.CT?RICE�r JOFs COST mea::s the actual or es�ima;-�d dellar amour.t char�i:d fo:tne�3e:m.it?ed
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 material, equipment, labor, or installation 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. 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 contract price under $1,000,000 or $.50 - whichever is
greater. For valuations over $1,000,000 call the Department of Inspectional Services for the price.
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 Minnesota
State Building Code, and certifies th�t all statements made on this application are complete, true
and correct. �,:
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A licant's Si nature:�'� L�.-�''` /" �—�--� Date:
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Approved By: Date:
DATE TIME
CITY OF ORONO CALLED IN '�S �( �- ���
INSPECTION NOTIC SCHEDULED ��'��Z�p� 1� ��
PERMIT NO. �� 7� COMPLETED ��'�Z��"��_ �'�• ��
ADDRESS ` C f �
OWNER �h-fi�C�-�-� CONTR. ��`
TELEPHONE NO. �7��Y "�c�-�
� DESCRIPTION �uX� G�(�
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING .�f"I_ CHANICAL FINALJ 18 EXCAV/GRADINGIFILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
� 04 WALL�D. 12 WATER HOOK-UP 34 TREE REMOVAL
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Q L 13 METER SET(TURN ON 17 SITE INSPECTION
� DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
Q OWNERICONTRACTOR TO MEET YOU: YES NO
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� COMMENTS:
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GW ORKSATISFACTORY:PROCEED iXdPROJECTCOMPLETE
� ��' CORRECT WORK 8 PROCEED ` / ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r- pHOTO TAKEN
INSPECTOR WILL RETURN
�-1 CITATION ISSUED
C:STOP ORDER POSTED.CALL INSPECTOR
G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73rJ7
OwnerlContractor o s' • _
Inspector.
Whit opyllnspector's File Canary CopylSite Notice