HomeMy WebLinkAbout2001-P04501 - mechanical PERMIT
�I j Y O F O RO N O Permit Number:
'2750 Kelley Parkway - PO Box 66 P04501
Crystal Bay, Minnesota 55323 Permit Type: Mechanical permits
(952) 249-4600 Date Issued: �oi»i2oot
SITE ADDRESS: 140 Golden view Dr
LONG LAKE, NIl�I 55356
P I D: 33-118-23-43-0023
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Mechanical Permits Permit Sub-type(s): Mechanical Undefined
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Basement air exchanger
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 2,168.00
State Surcharge Fee: $ 1.08
TOTAL FEE: $ 36.08
APPLICANT: Countryside Heating&Cooling OWNER: CHRIS J&ELIZABETH M HICKOK
6511 Hwy 12 140 GOLDEN VIEW DR
Maple Plain, MN 55359 LONG LAKE MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI� REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK 1N STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
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PPLI NT PERMITEE IGNATURE DBY SIGNATURE
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Copies: 1-File(Signitures Reguired), 1-Applicant, 1-Monthly Repor[s, 1-Assessing, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL IVFORMATION
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 2 working days.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL
YOL RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON
THE JOB SITE. �
3. Mechanical DesiQns - 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. Identification of and specifications for water heating equipment
shall also be 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 249-4600. 24-hour notice required.
7. House Heating Test Record must be submitted before final.
Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification.
INCONIPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 249-4600.
Please check one: New �ddition Repair Replace
✓�Zesidential �Commercial
JOB SITE: ►�p �,o;.-t�C rv v�C=_i.�, R-'Sa Zip: s5'�S�
Owner's Name: '1.1�c K_p\� Telephone Number: �5,� - �� 3 -��{.�
Mailing Address: �pvv��_ City: Zip:
Contractor's Name: Counr;2`r���E t-��-l-c�� Telephone Number: ��e'� -��4�1 c..c�z.�
Nlailing Address: �,��� � W t�rn c ��_ City: �A��E ('���r�7ip: ��
SYSTEM DESCRIPTION
HEATII�'G SYSTEMS
Quantiry:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H. Power
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FIREPLACES
Gas factory fireplace
Wood burning factory fireplace with flue
Wood Stove
Wood stove with flue
Brand Name Model No.
VENTILATION
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. � Other Fans: Locations [y�SC'���ti� cfm
A�2 ��.C'i t/��..;C��
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation Removal
Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PERIVIIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
.�l Cv 't . C'� �' x .0125 $ �,��..t^��'�
(contract price) � ��
2. State Surchar�e. ** Add the State Building Code Division
Surcharge to each permit. a � (��, �� x .0005 $ _ 1-�-�-��
or $.50, whichever is greater (contract price)
3. Posta�e and Handling (Only mail-in applications) $ -�-}-�b"'
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 ta the customer
for the work done. If any material, equipment, labor, or installation are furnished by the owner, tenant or
any other party the reasonable market value of such items must be added to the estimated cast 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.
'�* The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or $.50 - whichever is greater.
For valuations over $1,000,000 call the Department of Inspectional Services for the price.
The undersigned 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 th�� Minnesota
State Building Code, and certifies th 11 statements made on this application are complete, true
and correct.
Applicant's Signature: Date: 1v "��-O 1
Approved By: Date: