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Home My WebLink About2014-00555 - gas line only � CITY OF ORONO ., * 2 0 1 4 - 0 0 5 5 5 * 2750 KELLEY PARKWAY pATE �SSUED: 06/03/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2690 FOX ST PIN : 04-117-23-42-0003 LEGAL DESC : AUDITOR'S SUBD. NO. 229 : LOT 000 BI.,OCK 000 NERMIT TYPE : MECHAN[CAL(> $500) PROPERTY TYPE : RFSIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY VALUATIOIV : � 2,800.00 NO"I�I;: R[�'�'NING G:1S1.1V�I:"I�(> POOL f IEATI�,R,TO n ['IRI;NLi1Cl�:AND OUTDOOR GRILL APPLICANT MECHANICAL 50.00 STATE SURCHARGE MECH (VALUATION) 1.40 ME"I'RO GAS INSTALLERS TOTAL 51.40 685 141ST LANE NW ANDOVER, MN 55304 Payment(s) (763)754-71 19 CHF;CK 14713 51.40 Minnesota State License#: mech-MF3003162 OWNER JACOBSON, MICHAEL 2690 FOX ST WAYZATA, MN 55391- AGREEMENT AND SWORN STATF.MENT I�he work for ti�hich this permit is issued shall be perfornred accordine to thc approved plans and specifications,applicable City approvals,and thc State[3uilding Code. This permit is for only the work describcd and does not grant permission for additional or related work which requires separate pennits. All provisions of laws and ordinances govcrning this typc of work shall be compied with whether or not speci�ied herein.'�his permit will expire and become null and void if construction authorized is not commenced wiUiin 180 days of thc date of issuance,or if construction is suspcndcd t�or a period of 180 days at any time after work has commenced. �I�he�ippiicant is responsible for assuring all required inspections are requested in conformance w�h the State I3uil ' g Codc.This permit may he revoked al a�rv timc or d cause. / �' �� J�� 3 / i i ,lpplicant Permitee Signature Date Issucd ��Signaturc Date � ` /�7r3 I FOR CITY USE ONLY � �, �O A T City of Orono 1 yO P.O.Box 66 Date Received: Permit# 2750 Kelley Parkway I Crystal Bay,MN 5�323 Approved By: Amount$: ��` Phone(952)249-4600 Fax(952)249-4616 a i S � F �,� �qKESHo�� CITY OF ORONO —MECHANICAL PERMIT (All Commercial permits m�st be approved b�the Building Official or Inspector and/or Fire Marshall) GENERAL INFORMATION 1. You may apply for mechanica] permits by mail ar 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 Desi�ns—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. 4. When any new construction or remodeling is involved, a separate building permit must be obtained. 5. Al] work must be done in accordanee 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 Recard must be submitted before final. TYPE OF PERMIT (Check All That Apply) -�Residential ❑ Commercial (Approval Required) �New ❑ Additional ❑ Repairs ❑ Replace Job Site / Owner Information: Site Address: � - ��/ � Qy�, •/ -� Owner: / ' '� �-� 0�°-,c'l �� Mailing Address: �� / V �L�j�- �fi, City: �/�.�Tn�%� Zip: Home Phone: �� /��U�� Alternate Phone: ��J /�� —� �.�� Contractor Information: � Contractor: �� ontact Person: �� Address: l,C G� ��S�/�^-P ��V State Bond #: City: l.�!/��'�'► ZipL��Expiration Date: Phone: �(I�� Z� 7�� Alternate Phone: �� 1 � �� l �� ❑ Insurance—Current: 1 � a � MECHANICAL SYSTEMS BE1NG 1NSTALLED f � 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 VENTILATION ❑ Na Kitchen Exhaust duct recirculating cfrn ❑ No. Bath E�chaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORACE (Must be approved by Fire Marsleal!if proposing to abandon tank in p/ace.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside LP Gas: gallons Other: GAS LINE ONLY � � Outdoor Grill � Other/List What& Where: � f�0�Dobg1�� 2 �0 000 � � � � PERMIT FEE CALCULATION(S) 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$500.00 ar less; excludin�the cost of the fixture or appliance: and 3. Is improved, installed or replaced by the homeowner ar licensed contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mai]-In Fee (If Applicable) $ 2.00 Total Permit Fee $ PERMIT FEE CALCULATION(S)—JOBS OVER $500.00 If above does not apply; follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) �� X .ol2s $ (con ract 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 undersig��ed 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: �� 3 � � � DATE TIME � CITY OF ORONO CALLED IN �-�_� � INSPECTION NOTICE SCHEDULED PERMIT NO.--ZD/�/_�S MPLETED ADDRESS OWNER TE PHON NO.�/.��r7'-.3T�� CONTRACTO � G �� DESCRIPTION .—(.�,�L�- � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL � ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP � ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO c��, COMMENTS: � a J� 4'¢s �i?GS " �DOd/ `i�!4L�e✓i o _—�[�/� ��Jaa✓ 4�e s �'• P- � �. � ° �� D�s t • f �s, _�� a �'�'` s,.� W ,� h� o,�. �• � ,�. � Q z �/l .3 S�D��¢L�e 4�% -��ft �tal�."� � �3o ms� s�� 6 -3- �4 _ � / � 6 i�� e c � w� C ' h'�G�.�c� ,,,,, �a, k d -- (JUev4f� � � � �WORKSATISFACTORY:PROCEED �f] P OJECT CONiPLEfE �f' rQ�� w ' O`�ORRECT WORK&PROCEED �E CERTIFICATE OFOCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Cal1 for the next inspection 24 hours in advance. (g52) 249-46�0 OwnerlContractor on site: ��+ inspector. 'e Copyllnspector's File Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. o�/�—��COMP�ETED � - '� ADDRESS �l� 1�d �`� �-- OWNER TELEPHONE NO. CONTRACTOR �o�� 4��ns�LlQ-''S �; DESCRIPTION 3 G�3 �� — � 4� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FI�LING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS � Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT Q ❑ DEMO-SITE ❑ SEPTIC MAINT. `�LLOW-UP 2 ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a o �`li�,� dai-.+�<�L' �a�lso �j_ -�<..t� d-�` � Q� :- �e s z. � �..�' . ��z s�Qc�.�„ �s n ° � - s- i � 6.� �, ..�. � W � Q � 2 W � - W � �i•�.�1-� � a W� ❑WORKSATISFACTORY:PROCEED OJECT COMPLETE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: Inspector. �- White Copyllnspector's File Canary CopylSite Notice