HomeMy WebLinkAbout2016-01436 - mechanical • CITY OF ORONO * 2 0 1 6 - PJ 1 4 3 6 *
2750 KELLEY PARKWAY DATE ISSUED: 1 U14/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 145 CYGNET PL
PIN : 04-117-23-22-0012
LEGAL DESC : SWAN LAKE ADDN
: LOT 006 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 3,700.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
REPLACE(1)DAIKIN NATURAL GAS FURNACE
80,000 INPUT BTU'S
64,000 OUTPUT BTU'S
APPLICANT MECHANICAL 50.00
CENTERPOINT ENERGY STATE SURCHARGE MECH(VALUATION) 1.85
6161 GOLDEN VALLEY RD MAIL-IN FEE 2.00
BUILDING A
TOTAL 53.85
GOLDEN VALLEY,MN 55422- Payment(s)
(763)512-2765 CHECK 20666 53.85
Minnesota State License#:mech-MB003503
OWNER
BADER, LOUIS&NYLA
145 CYGNET PL
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved pians and specifications,applicable City approvals,and the
State Building Code. This permit is for o�ly the work described and does
not grant permission for additional or related work which requires separate
permits. AlI 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. --
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Applicant Permitee Signature Date Issued Signature Date ��
RECEIVE Fo� ITY USF,ONLY /
O City of Orono � � !/ �
� � P.O.Box 66 �ry4` � Date Kec ive�: Permit# ��Q' 7
� 2750 Kelley Parkway NU M � 20�� z �
Crystal Bay,MN 55323 Approv By: Amount$: �✓
Phone(952)249-4600 Fax(952 249-461
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c+-nr b�oR�N
�qk�SHO�@ CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Quilding Ofticial or Inspector and/or Fire Marshall)
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 two working days.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SI7'E.
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 mode;. Data shal] 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) [Backflow Device: ❑ AVB ❑ PVB]
❑ New ❑ Additional ❑ Repairs ❑ Replace
Job Site/Owner Information:
Site Address: 145 CYGNET PLACE
Owner: NYLA BADER Mailing Address: 145 CYGNET PL
City: ORONO, MN Z�p. 55356
Home Phone: 952-449-9229 Alternate Phone:
Contractor Information:
ContraCtor: CENTERPOINT ENERGY Contact Person: JOANN ZINKEN
AddCeSS: 6161 GOLDEN VALLEY RD,BLDG A State BOrid #: MB003503
Clty: GOLDEN VALLEY Zjp; MN Expiration Date: osi2oi2o�s
PhOrie: 763-512-2765 Alternate Phone:
OLD REPUBLIC INSURANCE CO.
❑ WORKERS COMP&EMPLOYERS LIABILITY
InSuranCe—Current. POLICY#WLRCC48597075
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1
MECHAMCAL 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: DAIKIN
ModeL DM80HE080
Fuel: NAT. GAS
Flue Size:
[nput BTUs: $0,000
output BTUs: 64,000
CFM:
COOL[NG 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
VENT[LATION
❑ 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 Mars/zall if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What& Where:
2
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. �'.
PERMIT FEE CALCULATIONS
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
3700.00 x .0125 $ 50.00
(contract price) (minimum$50.00)
2. STATE SURCHARGE
3700.00 x .0005 $ 1.85
(contract price)
3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 53.85
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials, labor, profit, and other 6xed 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 perrnit 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 issliance 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: 11/04/16
3
Hol«c� hc��ting test record REC������ CenterPoint,
��_L � ��:
Energy
ci-�oF oRONa
Owner �e. Controls Conversion
Address� �G�/q����. Apt Thermostat�nei r,e/� Heai plug Vent Size � ��
City �-o,no Valve t�(//� Kind of liner/size yQ �Q�� 6��
Heat loss Date htg.insi /f- �l/_ Limit �; � Drah hood�,,,p�{«� Regulator
Sold bv CenterPoint Energy Limit setting /'6� filters:Size%(�(��,x y Number
Installed bv CenterPoint Energy Fan setting T�✓I,t� Chimney locations: �j Inside 0 Outside
Electrical work bv CenterPoint Energy Pilot type /V� Chimneyconstruction �{ �i¢u�
Heat type � FA 0 Space heater Pilot make — Wiring Tesi tag
Gas line by �'�E Piloi model � Lighting Inst Date tested /�-�=/L
Unit heater Oiher Pilot timing � Comvanv testinQ CenterPoint Energy
Gas design Pressure:Hi fire/Lo fire ��,� J . 7 Tester's name � q f�r�h
K Model �j�/�f�_,U Percent CO2 �o, 7 �/_q
Make q+ i�
Serial no./�Q.E�/�7�
Input CFH�;d G�'j Percent Oz q.s �3,y
Stack tem���(p�Percent CO!'�3 �}
Input �((J,Qr'�
CNP 235(11-2008)