HomeMy WebLinkAbout2016-01439 (mechanical) � CITY OF ORONO * Z 0 1 6 - 0 1 4 3 9 *
2750 KELLEY PARKWAY DATE ISSUED: 1U16/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2528 CASCO POINT RD
PIN : 20-117-23-21-0015
LEGAL DESC : TOWNSITE OF LANGDON PAEZK
: LOT 003 BLOCK 006
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 4,200.00
NOTE: ALL TEST[NG REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
(1) AMANA FURNACE
APPLICANT MECHANICAL 52.50
STATE SURCHARGE MECH(VALUATION) 2.10
BLUE OX HEATING&AIR MAIL-IN FEE 2.00
5720 INTERNATIONAL PKWY
NEW HOPE, MN 55428- TOTAL 56.60
(612)238-9709 Payment(s)
Minnesota State License#: mech-MB671957 CREDIT CA�D 0100 56.60
OWNER
SVANG,MARIE
2528 CASCO PT RD
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 the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
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 l80 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 [ssued By ignature Date
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� FOR CITY USE ONLY
�O A} City of Orono
i y P,O.Box 66 Dare Received� Permit A
Q 2750 Kellcy Purkwuy
' Crysml l3uy,MN 55323 Approvcd By, Amount$:
Pl,onc(952)Z49-4600 Fax(952)249-4b16
� y��''xFSHo��'G� CITY OF ORONO—MECH,ANXCA,��'��ZT
i (Au Commcrciai permits must bc approvcd by tlie Duilding OCficial or lnspcc�or and/or Firc Marshall)
�� ,iCxENERAI�TNFORMATION
l. You may apply for mechanical permits by m<�il or in person�t the Ciry offices. Applicdtions will
be reviewed a�ad a permit will be issued within two working days.
2. Permit eards will bc scnt by rctum mail aRer a review is Completed. PF�MTTS ARF NOT
� VALID U'�1TTL YOU RECEZV��,��IZMIT. WaRI(1vMUST NO'�13�C1N UNTI�,Ti�lr
PF.RMI'C'CA�D IS POSTED UN THE JOB SITE.
i 3. Meeh�nie�l besiens—Compleie eelculations,dctails and specifications are required for each
hcating,ventilation,humidificatior�-dehumidification,and air conditioning install�tion includiag
heat aoss/I�eat gain c�lculation,design temperacures,equipment ra�ings and identifeation as to
type,mAnufnelurer 2nd modcl. Data shall bc presented on form provided.
4, When any ncw construction or remodeling is involved,a separate bullding permi[must be
obtaincd.
5. All work must be dona in aeeordanee wilh lhe Uniform McchanicaI Codc/Statc Building Codc
rcquircmcnts.
C>. All work must be inspected(rough-in and final). Cnll(952)249-4600.
(24-48 hour notice required)
7. House Heating Tcst Rccord must be submitted before fiai�l.
" ��'j�E�'"�'�'���'+''''''I�,I';���e.'� � TYI'E OF��'�R�,]V�'�'� �� � � �
�"j�'��� ''''r' ���"�� Check All That.A I
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������;�!;�I�il;li+�i;�i�,l;;'�;I�lii�+�;i�� '
Q RCsidential ❑Commercial(Approval Required)
❑New ❑Additiona] ❑Repairs �eplace
�� ''��;Pq;li;�''�S'i�te,;Yl,,,0,'wner ln�orma�ion: � �
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' Sitc Address: �� ���� O ��
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; Owner:--��(�Q �v G'h C� N�aiai�g A,ddress: �\� �
' p �� ��j�G1 .
Ciry: S� Zip:
Home Phone: wI d'"D a`�� ��j�� Alternate Phone: '� ��
CdrltrtaCt�Sr Infc�r�ii�tii�ii;�,�� � � , ;r� � ,�' �;�,�,�1��; i
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Contractor: ��1�7� � �(C�C���,r�can��t PerSan: Jennie Wood
' AddreSs: 5720 Intarnational Pkwy State�ond#: 1rn _��� 1�'��
cl�y: New Hope Z��: M N Expiration D�t�: �Gl� f
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612-238-9709 "
Phone: Alternate Phone:
� insurance—Current:
Owner's Insurance �
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� Note;Al]Geothermal Systems wiI]now require a Site Plan&Revicw by our Building Official.
iS'THiS GEOTHERMAL? ❑Yes �No
I HF,A,'��NG SYSTEMS
Qu.�ntity: 1
cvlalce: 6
Model: n
IFucl= .
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� 1'lue Size:
� Tnput�'�Us: �0 0
; �u�p�tB-�5� C��l,o D�
� C��:
! ('O . ' SXST�MS
� Qu�ntily:
Mahe:
Model:
1'ons:
H.PUwcr
FIREPLACES
❑ Gas Pacto�y Firep rAnd NAme:
❑ Woud 13urning Firepldcc
❑ Wood Stove ;�fodel No.:
❑ Wood Stove with l�lue/ sonry
VENTILATiON
❑ No. Kitchen Cxha duct rccirculating cfm
❑ No. Bath Exhaust st ha ct outside) __ cfin
❑ No. Other�'a . Locations cfm
FUEL STORAGE (Mu. a�Sprnvcd 6y Fire Marshall if osing to aba don lank in place.) j
I
❑ inst�llation ❑ i
Fuel Oil� ons Underground ❑Insade ❑Outside �
J�P Gas: .,.,,_ . ._ gallons �
Other: �
G.9,S Ll�k,ONLY
i
❑ Outdoor Grill ❑ Ot x .�st W�at&Where: „ ..._
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11/15/2016 TUE 16: 19 FAx 612 822 5408 A1' � MA�ter Plumqimg �00�/044
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❑ � Yes,this section�pplies
The replace�nent of a Residentifll fixture or apptiancc that meets �ree of the�'ollowi�ag requirements:
E 1. Does nat rcquire modification to electrical as service.
�` 2. Has�total cost of$500.00 or less;exel n the cost of thc fixture or appliance:and
, 3. Is improved,installcd or rcplaced b e homeowner or licensed contractor.
� Skip next section,if this Ap ' s; Cost of Pcrmit $ 15.OQ
State Surcharge $ 5.00
MAiI-In Tee(lf Applicable) $ 2.00
, Total Permit Fee $
� do�. , � ,� �, , � , �a�°� �� �;a�,�F��.��a���; ► �i �� � � a��
if above does not apply;follow guidelines below:
l. C;ONTRACT PRTCT *is 1.25%of contrAct price with a(Minimum Fee af$50.00)
� �'d-QU x.0125� � � ��U
(coniract pricc) (minimum$50.00)
2. ST'ATE SURCHARGE ` A ;(�� `�,
_ `�� �/�� x.�005 5 �p `tJ
�(cnntract pricc)
3. POSTAGL&1-lANDLING(Only on Mail-Tn Applications) $ 2.00
4. TOTAT.�'TRMIT TEE(Add Lines 1-3 Above) $��� .�(�
■ * CONTRACT PRICE or JOB CQST means the actual or estimated dollar amount ch�rged for lhe
pennirted work including m�teriAls,IAbor,prorl,and othcr fixcd costs. it is the amount to be charged
to the cusiomer for the work done, If any matcriat,equipment, labor or installatzoaas are fur�xiskaed by
thc owncr,tenant or any other party,t�xe reasonable market vAlue of sueh items must be added to the
estimated cost or contract price for permit fen purposcs. In thc cvcnt that there is a disputc on the
flmount of thc job cost,thc City may request the submission of a signed copy of the actual conuact.
,.,.�,,y,. r. � ... . �����8 f� "ir�irv'rr",�:„��<v,"y.cr:�;'
.�i:: � ,6r h>��i;.� ,r.� ,�.r
The undersigned hereby ap�lies to the Caty for issuance of a Mechanical Permit, a�;rees 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 mad is a��ilicatiqn arc cpm�lctc, truc and :
correct.
Applicant's Sibnature: Date: ` � / � � /�`f�
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