HomeMy WebLinkAbout2016-01337 � � CITY OF ORONO * z 0 1 6 - 0 1 3 3 7 *
2750 KELLEY PARKWAY DATE ISSUED: 10/19/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3960 BAYSIDE RD
PIN : OS-117-23-22-0015
LEGAL DESC : AUDITOR'S SUBD.NO. 203
: LOT MB BLOCK MB
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
ACTNITY : O/S GENERAL
VALUATION : $ 2,100.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
HEAT N GLO GAS FIREPLACE
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.05
CONDOR FIREPLACE& STONE CO. MAIL-1N FEE 2.00
8282 ARTHUR ST NE TOTAL 53.05
SPRING LAKE PARK,MN 55432
(763)786-2341 Payment(s)
CREDIT CARD 6743 53.05
OWNER
LOVELESS, CHRISTOPHER&KATIE
3960 BAYSIDE RD
MAPLE PLAIN,MN 55359-
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 the
State Building Code. This permit is for onty the work described and does
not grant permission for additional or related work which requires sepazate
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 time for due cause.
/ /
Applicant Permitee Signature Date Issued By Signature Date
' � FOR CITY USE ONLY
���0 cirv of orono ; ( �3�j
P.O.Bn�66 = Date Received: Permit���`
i 27�0 Kcllcy Park�v�y � - �'
r ,'� Crystal Lia��.MN 5532:� Approvcd By: _ Amount 5:��
� � �, � 'i Phonc{953)?d9--{GU(} Fax(952)249-�161( _ _
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�`F�-,,�.��f��>>t�" ' CITY OF ORONO - MECNANICAL PERMIT
_ _ (All Conimcrcial pcnnits must bc approvcd by thc Building Otticial or Inspcctor and/or Firc Marshnll)
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GENERAL INFORMATION
i. �Y ou may appiy tor mecnanicai permits ny maii ot�in person at the l,ity oItices. Appiications wi'li
bc rcviewed and a permit will be issued within twu workinb days.
2. Pennit cards will be sent by return mail after a revicw is com�letc�l. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUS'l'NO"I� BEGIN UNTIL'['HE
PERMIT CARD IS POS"I'ED ON THE Jt)B SI"I'E.
3. Mechanical Desi�ns - Completc calcufations, details and specifications are required for ench
heating, ventilation, humidification-dehumidification, and air conditioning installation inclttding
heat loss/heat gain calculation,dcsign temperatures,equipment ratings and i�entification as to
type, maiiufacturer and model. Uata shall be presented on form provided.
4. When any new construction or remodeling is involved,a separate building pennit must be
ohtaincd.
5. All work must be done in xcordai�ce with the Uniform Mcchanical Cocfe/Statc Building Code
requir�ments.
6. All work must be inspected(rough-iiz and final�. Call (952)249-4600.
(24-48 hour nuticc rcyuired)-
7. House lieating"I�est Record must be submitted before final.
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TYPE OF PERMIT
_ _ (Check AlI That Apply)
�lZcsiclential ❑ Commcrcial (Apprvval Requircd) [Backflow Device: ❑ AVB ❑ PVR�
�c�v ❑ Additional ❑ Repairs ❑ Rcplace
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ob Site /Owner Informatzon: �
Site Address: v� � �Sl-�G
� r � 1 ��� t. �1\, 1 1 _ - -
Owner:__ � l_..:(�. . �,..�� '�.. � \ �.y l ,,.. � � c__..���. �`
� � �- Muilin�J � � ; , �-1 �-
� Acl�lrttiti: u < �
City: ��,_'��L'" ��--'��U'�,�`� ZiP: .__---- -�,
Home Phone: � �� �� ��.i��1 � ��.,a � ,�Alternate Phone:
_ __..__. �.......
Contractor Information:
_ _�_ �_____ �
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Contractor: � � 1 �''�., ; c. �)t(�`�iii�tacft'Pci�c�n:
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Address: �i�r� ��.�"t.;��1,t,U�., �� Statc I3ond #: `�
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City: �� �"�U �.�1 ���i��• �..1 �' �.���ir�ition f��it�: � � v��.� �-�
l/�' ��' _� ��1�� � � ,�� --
� � � Phone: r_�`,,���,-���'. .. � �1lternatc ('he>n�:
� � -� �� �>\� 1' ❑ Insurance - Current:
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MECI�-IANICAL S�S"I'EMS BFING [NST�LLED
Note: All Geothermal Systems will now require a Site Plan& Review by our Building Ofticial.
IS THIS GEOTHERMAL? ❑ Yes���
HEATING SYSTEMS
Quantity:
��lakr:
Model:
Fuel:
Flue Size:
Input BTUs: _.__�..______--__--
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
1�IIZE:PLACI:S
Gas Factory Fireplace Brand Name: t�.� ��. � ��
� � __- - -
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Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
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 Marshal!if proposing to abando�t tunk in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑ Outside
LP Gas: gallons
Other:
GAS L1NE ONLY
❑ Outdoor Grill ❑ Other/List What&Whcre:
2
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C'ER1�1IT FCE CALCUL�1TtON�i �
1. CONTRACT PRICE * is 125%of contract price with a(Minimum Fee of$50.00)
�'` � � x .0125 $ � � �'
_ _ .__. _—
(contract pncc) (minimum SSQ.00)
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:. �1;111'. �liKl li,-�Kt�l'. -! _� � � ')
� --� �� x.0005 �
.�.
(conti�act pricc)
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 actua] or estimatcd dollar amoun[ charged for thc
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 o[her party, the reasonable market value of such items must be added to the
estimated cost or contract price for perrnit fee purposes. In the event that d�ere is a dispute on the amount
of the job cost, the City may request the submission of a signed copy of the actual contract.
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MECI�.�1N1C.�L PERMIT APPLiCATION AGREEMCNT �
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.
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Applicant's Signature �_ � ,' � -" " Date: � � I � �
.
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3
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/ 'D� TIME
CITY OF ORONO CALLED IN G�
INSPECTION I SCHEDULED � — � -��-�"�
PERM�T NO. �� coM Ereo
ADDRESS 0 �
OWNER TE E ONE 0�2 � ��� 7��
CONTRACTOR
� DESCRIPTION ��� � �
� ❑ FOOTING ❑ DEMO-FI L p D� ❑ SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ���` � ❑ EXCAV/GRADING/FILLINQ
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB �MECHANICAL RI �S� ❑ SITE INSPECTION
Q�RAMING�Te���(, ❑ MECHANICAL FINAL ❑ RATED WALLS
Z' G�l-1�i/��-+i4'1"•-�
� ❑ INSULATION �❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ��UNDA � L
� ❑ DEMO-SITE ❑ SEPTIC INSTALL
Q O�INNERICOKTRA(."T TO MEET YiOU:_YE8_NO
y CO MENTS: � - �• � �� �'�'^ �
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4�j ❑WORK�FACTOR'9:�ED , ❑ ECT COMPLET � �
� �ORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUWINCY
W
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMIPORARY
V BEFORE CONERINd PERMANENT
❑CORRECT UNSAFE COND�TION WRHIN HOURS. p pHpTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ��TAT10N ISSUED
❑INSPECTION REWIRED.CAIL TO ARRAN(iE ACCESS.
Call for the next inspectfon 24 hours in advance. (952) 249-4600
Owr�IContraator on sRe:
inspector:
Whits CapyRnspacto�'s FiN Canary CopylSit�NoGe�