HomeMy WebLinkAbout2008-00317 - mechanical CITY OF ORONO PERMIT NO.: 200�-003��
� 2750 KELLEY PARKWAY
'} ORONO, MN 55356- �ATE IssuEn: 10/22/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 3585 FREDERICK ST
PIN : 20-117-23-12-0025
LEGAL DESC : T[LLSONS VILLA CARMAN
: LOT 005 BLOCK 001
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 1,200.00
NOTE: 1 MODINE UNIT HEATER-GAS
SIDEWALL VENT FOR HEATER
INSTALL NEW GAS LINE
APPLICANT MECHANICAL 35.00
KLEVE HEATING&AIR STATE SURCHARGE MECH(VALUATION) 0.60
6365 CARLSON DRIVE SUITE G TOTAL 35.60
EDEN PRAIRIE, MN 55346-
(612)941-421 1
OWNER
VRCHOTA&MITCHELL KUSY, SCOTT
3585 FREDERICK 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 the
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 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.
Y�"� � / / / /
Applicant Permitee Signature Date Issued By ' nature - Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBE BOVE.
t , � FOR CITY USE OfYLY
,. O��O` City of Orono
P.O.Box 66 Date Received: Permit k
�,,, 2750 Kelley Parkway
� ,I,�Z�;' � Crystal Bay,MN 55323 Approved By: Amount S:
��j���.` (952)249-4600
CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permia must be approved by the Buiiding Official 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 wilf 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. Ivtechanical Desiens—Complete calculations,details and specifications are required for each
heating,ventilation, humidification-dehumidification, and air conditioning installation including
heat loss/heat�ain caiculation,desi�n temperatures, equipment ratines and identification as to
:ype, manu:`,:ctur.;2r.d medel. Data shall be presented on form provide_d.
4. When any new construction or remodeling is involved, a separate buildin; permit must be
obtained.
5. All work must be done in accordance with the Uniform i�techanical Code,%State Building Code
requirements.
6. All work must be inspected (rou�h-in and final). Call (952) 2a9-4600.
(Z�-43 ho�r notice required)
7. House Hea[in;Test Record must be submitted before final.
TYPE OF PER,'�IIT �
(Check All That Applv) I
[�B.�S�idential ❑ Commercial (.-�,oproval Required)
❑ New �Additional ❑ Repairs ❑ Replace
Job Site / Owner Information:
Site Address: � 7�0� ��'�l-�E��a.
Owner: �'11 � �itailina Address:
Ciry: Zip: �
Home Phone: Alternate Phone:
Contractor Information:
Contractor:KlPVP F-Tt.g �, a/r In� Contact PerSon: Ashley Griffin
Address: 6365 a 1 �on nr Ste CState Bond n: gr,T_5F � � h�
Citv: Eden Frairie Zip: 553�6Ezpiration Date: 8/ 14/b9
Phone: 552-9�1 -4211 Alterna[e Phone: g�2—��5—i 2n2
❑ (nsurance — Current:
1
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°a.�;����t=`:''���''"•�'.r.w-r�'�IEG''HANICA.L4; YtiS�IV1 BEI�IG��ST�1L;L D�)�n�: ;�:� ����.r;r.., �''
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HEATING SYSTEMS
Quantity: (
Make: ��1�•
Model: �
Fuel:
Flue Size:
Input BTUs: ���
Output BTUs:
CF�I:
COOLING SYSTEIIS
Quantitv:
`ial:e:
tiiadel:
Tons:
H. Power
FIREPL�CES
❑ Gas Factory Eireplace
❑ Wood Bumin� Fireplace
❑ 1Vood Stove ,
❑ Wood Srove \Vith Flue
Brand�lame: titedel No.:
VENTILATiON 1M_��� � �i��L n ,-y�„ `fb1� �
1�1 1�) �)VU�n�" ll� � 1
❑ No. Kitchen Exhaust duct recirculatin�� cfm
❑ No. Bath E�chaust(must have duct outside) cfr,�
❑ No. Other Fans: Locations c`n�
FL'EL STOR�GE (1tliST BE APPROVED BY FIRE �tARSH.�,LL) _
❑ [nstallation ❑ Remo��al
Fuel Oil: ;allons ❑ Under�round ❑ lnside ❑ Outside
LP Gas �a(lons
Ot}�er:
G.-�S LINE ONI�Y
❑ Outdour Grill � Othcr ' List \L'h:tt �°_ \�"hcrc: `r
�
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�t,�,�y ��,y, �y��ti s�f ��t� ,,�,ERMIT.FEE,�CALC.UI,ATION(S);,� `4 ;4} ,� f� '-� �;� , ;��
'..:;':� � t,.,�;s'��.,-� f� `=,=�BASED OFF,:.2002,STATE STATIJE ,,.:,-=..._u�� ��-� �•-
❑ Yes,this section applies
The replacement of a Residential firture 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 appiiance: 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 Surchar;e S 50
Mail-In Fee(If Applicable) S 1.�0
Total Pcrmit Fee S
� PERMIT FEE CALCUI;ATION(S) -JOBS OVER $500.00
If above does not apply; follow ouidelines belo�v:
l. COtiTRaCT PRICE * is 1.��4a of contract price with a (tilinimu Fee of 53�.00)
� � .01�� 3� �
/ (con�rac;pnc.� �minimum��=00)
2. ST.-�TE SL'RCH.-�RGE " ,�,dd th: Staie Bld� Code Di�. Surchar�e (�[inimum r��ors.-n>
IC�'"'' x .000� S • lL V
(contract pnce) (m�nimum 5 :01
3. POST.-�GE g H.-��'DLING (Onl� on tilail-(n .�ppiications) S 1.�0
�
-t. TOTAL PER��IIT FEE (.�dd Lines 1-3 �,bove) S '
• ' CONTR.aCT PRICE or JOB COST means the actual or estimated dollar amount char�ed for the
permitted �vork includin� materials, labor, profit, and other fixed costs. It is the amount to be char�ed
to the customer for the work done. If an� material, equipment, labor or installations are fumished by
the owner, tenan[ or any other party, the reasonable market value of such items must be added ro the
estimated cost or contract price for permit fee purposes. In the e��ent that there is a dispute on the
amount of the job cost, the City may request the submission of a signed copv of the actual contract.
• ** The STATE SURCHARGE is .0005 of the Buiiding Department at (9�?) �=�9--1600 for the price.
� _- � ivIECHANICAL PERMIT APPLICATION AGREEMENT
The undersiened hereby applies to the City for issuance of a Nlechanical Permit, a�rees to do zll
�vork in strict accor nce 'th the ordinance e Citv and the re�ulations of the Sta[e of
�vtinnesota, and rtifies that II statement ma o this application are complete, true and
correct.
Applicant's Si�n ure: Date: I
,� Reset Form
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