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CITY OF ORONO PERMIT NO.: 2009-00012
2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE IssuED: OU13/2009
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1205 FRENCH CREEK DR
PIN : 10-117-23-23-0001
LEGAL DESC : FRENCH CREEK
: LOT 001 BLOCK 001
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 2,200.00
NOTE: 1 PAYNF,GAS HEA"I'ING SYSTEM
APPLICANT MECHANICAL 35.00
VOGT HEATING&AIR COND
3260 GORHAM AVE STATE SURCHARGE MECH(VALUATION) 1.10
ST. LOUIS PARK,MN 55426- MAIL-IN FEE 1.50
(952)929-6767 TOTAL 37.60
Minnesota State License#: 61725
OWNER
W[NSLOW, CLARK& SHARON
]205 FRENCH CREEK DR
WAYZATA, MN 55391
AGREEMEIYT AND SWORIY STATEMENT
"I'he work for which this permit is issued shall be performed accordin�to
the approved plans and specitications,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
permi[s. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specitied herein.This permit will
eYpire 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 atter work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.'I'his permit may be
revoked at any time for duc cause.
`,�1'l-Q� (�.> / / / /
Applicant Permitee Signature Date Issued By, ature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[ D ABOVE.
�; �.I I ��1�
FOR CITY USE ONLY
;�0� City of Orono
P.O.E3ox G6 Date Received�, Permit#
� � 2750 Kclley Park��ay
.� � "�• � ' (l'ystal 13ay,M�'>5323 Approved By: Ainount$:
�"� �� � ',� o`�� (952)249-4600
..�l�h,h'3iHp��'�
CITY OF ORONO— MECHANICAL PERMIT
(All Commerci:�l permits must bc�ppro��ed by the Building Offici�l or lnspector and/or Pire'�larshall)
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City officcs. Applications will
be rcvic��ed and a permit will bc issucd within two worl<ing days.
2. Permit cards will be sent by return mail after a review is completed. PERMI'['S ARE NO�'
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THI?
PER111T CARD IS POSTEll ON THE JOB SITE.
3. Mechanical Dcsi�ns—Complete calculations,details and specifications are required for each
heating, ��entilation,humidification-dehumidification, and air conditioning installation includii�g
heat lossineat gain calculation,design temperatures,equipment ratings and identification as to
type,manufacturer and modcl. Data shall be presented on form provided.
4. When any new construction or remodeling is involved,a separate building permit must be
obtained.
5. All worl<must be doi�c in accordanec with the Uniform Mechanical Codc/State[3uilding Code
rcquiremcnts.
6. All �vork must be inspected(rough-in and final). Call (952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must bc submitted before final.
TYPE OF PERMIT
(Check All That A I )
� Residential ❑ Commercial (Approval Required)
❑ Nc�v ❑Additional � Repairs ✓Q Replace
Job Site/Owner Information:
Site Address: 1205 French Creek Drive
Owner: Clark Winslow Mailing Address: same as job site
City: Z.ip:
Home Phone: �952)404-2889 Alternate Phone:
Contractor Information:
Contractor: Vogt Heating,AC,Plumbing Contact Person: Mike R.
Address: 3260 Gorham Avenue State Bond #:
C'ity: St. Louis Park Z�p:55426 Expiration Date:
Phone: �952) 929-6767 Alternate Phone:
❑ Insurance—Current:
1
\ .
MECHANICAL SYSTCMS BEING INSTALLED
� �ote: All Geothermal Systems will now require a Site Plan &Resicw by our Building Official.
[S THIS GEOTHERMAL? ❑ Yes ❑ No
IIL:A"1'ING SYSTEMS
Quantity: �
Mul;c: Payne
nTo���: PC��9MT�tv�¢5�
Fucl:
gas
Flue Size:
Input B"I'Us:
5n,000
Output [3TUs:
46,000
CFNI:
COOLINC SYS'TEMS
Quantity:
Makc:
Modcl:
Tons:
H. Po�vcr
I�IRI�PL.aCES
❑ Gas Factory Fireplace Brand Name:
❑ Wood B�n-ning Fireplace
❑ Wood Stovc Model No.:
❑ Wood Stove With Fluc
�'GtiTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
� No. _ E3ath Exhaust(must have duct outside) cfm
� No. Other Fans: Locations cfm
I�l`LL S"1'ORAGE (MUST [3E APPROVED BY FIRE MARSHALL) If proposing to abandon tank
� Installation ❑ Removal in plaCe .
Fucl Oil: gallons � Undcrground ❑ lnsidc ❑ Outside
LP Gas: gallons
Other:
GAS LI\E ONLY
❑ Outdoor Grill � Othcr/List What&Whcre:
2
Jar-�A}`'"14, Z��9,m10: 47RM�ITY O���G �7 +9622d94616 7-1N0� 923,oz�ooP� 2-652
f
/d05" �nc% �� �
� � �' � . . � `P.CRMTT•,FEE�C�AT;CUI;.AT � ' (��"•:'.� �'-:•:!.�k;°'' '. � � ; � .
, . . � ; .��•��S�D 'OEF.�,20�12�STA��1'�.aT��`UE�:��;'����:'��•�;,��•-�:, � ' � ,
❑ Yes,tl�is scction applies
Thc rcplycemenL of a�tc ' r e e iancc that meet5 dll T�hree of ihe following��cquircmcnis:
1. �es requirc�rodification to electrical or�as service.
2. H�s a ior s oF$500.00 er lcs�;t c � + Zhe cosc of�hc fixturc or&pplianct:nnd
3, Is improved, instelled or replaoed by the homcowner or lieensed con�racco�'.
Skip ncxt s�cNon,if ihis�pplics; Cflst of Permit � _15 DQ
Srste Surchatge S�
Mail-rn Fcc(If Applicable) '�,_1 S�
'fot91 Permit Fee �
� � �PE�R,MfT,�'�E CAL�CULA'Z'1,O,N(S)'=„J'OE�S�'Odv�R�$500:O�Q,� � ` �
If abQve does not apply;follow guidelines below:
�, CON?Ra�,T AR1CF. ' is 1?5°/�of concract p�ce with a(Mlnilbu111 Fee aP$3�.U0)
2,200.00 X,0125 g 35.00
[cum�aec plico) (minimam S9S,00)
3, STA'����11�CHARCE '"�add the SCai.�Bldg Code Div.Surch�Tgc(Mini�num Fee ofS50)
, 2,200.00 x .00aS g �•10
�eon�c�price) (mi���mum S .50)
3. POS1'AGE&HANDLlNG(Only on M�il-Itt Applica�ons) S,,,�_, }_56
�. 'fOTAt i'CRMIT�C�(Add Lines 1•3 Abavc) $ 37.60
• w CONTRACf PR10E or 104 C1�ST means the �etut�l or Essimoced dollar amoui�s charged for the
permi��ed�vork in�luding macelialsr labor,proh�,And oih�r fixed eosrs. Ii is ihe am��unc ro b�charged
io ihe cusiomcr for the worlc done. fY any material, equipment,l3bor or insr�ll�tion��rz fumished by
ehc owner,t�nant or atly oclier parry,ihe reoso»able m�rkc��a1ue of sucl+ ir�ms m�,�be added so d,e
��Ii�lta�ed cos� or e�n►rse� pr;cz for porr��i� fcc purpose�, 1n the evens thaz there ir u dispucc on �hr
�moun� of the job cos�, cbc City may request ehe submission of a si�ed copy oi tl�r ac�ual conrract.
• �'�The S7aTE SURCHARGE is.0005 or chc Buildin�DepaRmenc ac(952)249-d61�0 Tor ihe prica,
1vL�C'HAN[CAL P1:RM,1�T APPLICATION'x�RL��c�i�NT' �
Tha undzrsigned lier�by applics to r,he Ciry for issuanc� of a Mechanic�l permii, agrees to do al1
work in sa•ict �ccordance with d�e ordio9nczs og �he Ciry and the ragularion, uf cl�e S�ste of
Minnasota, end certifie5 thal all srareme,nss made ou cizis applica�ion are coinplete, cruc and
conece. �
AAAlic�nt's Signature Date: Iw�T,��
� ca�� oq5
Reset�Form . � , ; 3
� � �� � J DAT � TIME ✓
CITY OF ORONO CALLED IN � ( �� �ll
INSPECTION NOTICE SCHEqULED l� � �
PERMIT NO. =�C��'�i� �'C�'��'�`� COMPLETED
ADDRESS I��`�� ����i'1Cj� �` I�C�C�K- l�l?
OWNER CONTR. l '��� ��C,�-f��j
TELEPHONE N0. �� f�� �(��C1 ` ��` �(r J
� DESCRIPTION ����� � ����1 �
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WA�L BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
T ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
� ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU�YES_NO
� COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLETE
W ❑ CORRECT WORK&PROCEED ;,P! SUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �j pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR -i CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� Z49-46QQ
OwnerlContractor on site:
Inspector. �-�+..... ;�r � I J �
White Copyllnspector's File Canary CopylSite Notice