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Home My WebLink About2011-01333 - gas line to range/dryer CITY OF ORONO PERMIT NO.: 2011-01333 � 2750 KELLEY PARKWAY • � ORONO, MN 55356- DATE�1ssuE�: 10/26/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 1685 FOX ST PIN : 03-117-23-44-0004 �� LEGAL DESC : HANSER ADDN �� : LOT 002 BLOCK 001 PERMIT TYPE : MECHANICAL(<$500) PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : GAS L[NE ONLY NOTE: GAS LING TO RANGE&DRYGR APPLICANT MECHANICAL(<$500) 15.00 SOUTHTOWN PLUMBING INC. STATE SURCHARGE MECH(<$500) 5.00 6636 PENN R[CHFIELD, MN 55423 MAIL-IN FEE 2.00 (612) 866-3057 TOTAL 22.00 OWNER HORNIG, STEVEN 1685 FOX ST WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and [he State Building Code. This permit is for only[he work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with��hether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time fortdue cause. `�-� � / / / / Applicant Permitee Signature Date Issued By gnature Date SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED A OVE. . � ��e� . r. s' ��zaa . y ��.;� FOR CITY USE ONLX . _,_-- City of Orono "�"" O'Q��O Date Received: Permit# .�'""`.�---.._.. P.O.Bo�66 2750 Kelley Parkway a '''� A Cn stal Baq,MN 55323 Approved By: Amount$: %� `' ' .� c Phonc(952)249-4600 Fa�(952)2d9-4616 C,�k[bNOp'f, CITY OF ORONO-MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL 1NFORMATION l. 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 two working days. 2. Permit cards will be sent by return 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 hea:loss/heat�ain calculation,design temperatures,equipment ratinQs 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 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(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 ❑Commercial(Approval Required) ❑ New ❑ Additional ❑ Repairs [�Replace Job Site /Owner Information: Site Address: ��-l� �� Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: ��l�r� �� r ru l�rt� Contact Person: � �fi vr,,ech«.��uc....ho vi,.r� �--Go�t.�-� Address: �ofo�� e ✓l ��e � State Bond #: (30�7`100 � �*!� �UU�`�� City: e� � Zip:�� Expiration Date: �� -��-�� Phone: �o l a '� �o "�'-S ;� Alternate Phone: ln l�-�/o'�� ❑ Insurance-Current: `(�� A-�fo-C��z��S 1 � MECHANICAL SYSTEMS BEING INSTALLED Note: All Geothermal Systems will now require a Site Plan & Review by our Building Official. IS THIS GEOTHERMAL? ❑ Yes �No 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 Brand Name: ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTiLAT10N ❑ No. Kitchen Exhaust duct recirculating cfm ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (Must be approved b1�Fire Mnrs/ra!!if proposing to abandon tank in place.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑Outside LP Gas: gallons Other: GAS LI'VE ONLI' ❑ Outdoor Grill [� Other/List What&Where: �__f/�g' 2 Ln�µ..�..� `� `L"`3�L �� - • • , PERMIT FEE CALCULATION(S) BASED OFF -2002 STATE STATUE �f 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$500.00 or less;excludine the cost of the fixture or appliance:and 3. Is improved, installed or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ oja.�; PERMIT EEE CALCULATION(S)-JOBS OVER"$500.00 � If above does not apply;follow guidelines below: I. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) x.0125$ (contract price) (minimum$50.00) 2. STATE SURCHARGE x.0005 $ (contract price) 3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ • * CONTRACT PRICE or JOB COST means the actual or estimated dollar 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. If any material, 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 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. MECHANICAL PERMIT APPLICATION AGREEMENT 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 certifies that all statements made on this application are complete, true and correct. Applicant's Signature: Date: Reset Form 3 DATE TIME ✓ CITY OF ORONO CALLED IN INSPECTION NOTICE ��33-3 SCHEDULED �LZ�� = � PERMIT NO. eZO!/—0�.33Z COMPLETED ADDRESS �lD[�5 l��C�� ""�'"��t�; `; _ s OWNER TELEPHONE NO. gb��'�7 CONTRACTOR � >: DESCRIPTION � �`��`-� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILIING Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS � ❑ 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 i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � � O � � O � W � Q � Z W � W � � d W� ❑WORK SATISFACTORY:PROCEED �R6pJECT COMPLETE W ❑CORRECT WORK&PROCEED ^: ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �' CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� 249-4600 OwnerlContractor on site: Inspector. � � � White Copyllnspector's File Canary CopylSite Notice