HomeMy WebLinkAbout2010-00124 - heating systems � CITY OF ORONO PERMIT NO.: 2010-00124
I 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE �SSUEu: 03/04/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 3355 GRAHAM HILL RD
PIN : OS-]17-23-11-0008
LEGAL DESC : GRAHAM HILL PRESERVE
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 1,200.00
NOTG: MODING,H-7�,NAT GAS,4",75.000 BTU
APPLICANT MECHANICAL 50.00
HEATING&COOLING TWO INC. STATE SURCHARGE MECH (VALUATION) 0.60
18550 COUNTY ROAD 8 I
MAPLE GROVE, MN 55369- TOTAL 50.60
(763)428-3677
OWNER
Charles Cudd LLC
AGREEMENT AND SWORN STATEMENT
The w�ork for�chich this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State f3uilding Code. This permit is for oniy 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 I 80 days of the date of issuance,or if construction is
suspended for a period of 180 days at any tin e after work has commenced.
The applicant is responsible for assurin II equired inspections are
requested in confo ance with the S te B Iding Code.This permit may be
rcvoked at � � u c for due cause'��
'c�
�,� /� � �
pp� ant Permi ee 'g t e Date Issued By S� alure te
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO
� FOR CITY USE'ONLY
� O,¢p�O City of Orono
P.�.Box 66 Date Received: Permit#
� �'��,,, 2750 Kelley Parkway
'�,�� � Crystal Bay,MN 55323 Approved By: Amount$:
�"����;�.�o` (452)249-4600
CITY OF ORONO —MECHANICAL PERMIT
(A11 Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical pemuts by mail or in person at the City offices. Applications will
be reviewed and a permit will be issued within rivo working days.
2. Pernut cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BF,GIN UNTIL THE
PEP.�YIIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Designs—Complete calcularions, details and specifications are required for each
heating, ventilation,humidification-dehumidification, and air conditioning installation including
heat loss/heat gain calculation, design temperatures, equipment ratings and identification as to
type,manufacturer and model. Data shall be presented on form provided.
4. When any new construcrion or remodeling is involved,a separate building pernut must be
obtained.
5. All wark must be done in accordance with the Uniform Mechanical Code/State Building Code
requu-ements.
6. All work must be inspected(rough-in and final). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT '
(Check All That A ly)'
�Residential ❑ Commercial(Approval Required)
�New ❑Additional ❑ Repairs ❑Replace
Job Site/ Owner Information:
Site Address: _��5 ���,���� �,�
Owner: C ��F.S l:uG�� Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
''Contractor Informationc
Contrac�ATINr & COOLING TWO INC. Contact Person:
18550 CountY �$�
Address:Maple Grove, MN 55369-9231 State Bond#:
www.heatcool2.com
City: Zip: Expiration Date:
Phone: Alternate Phone:
i
❑ Insurance—Current: ��^
1 ,�`` .`-�
= .
` '' Y<NTECHANICAL SYSTEMS BEING INSTALLED , , ` ,,,H: �
J
HEATING SYSTEMS
Quantity: I
Make: �
Model: `
Fuel: ,�'�cT
�l �/
Flue Size: 7
Input BTUs: ����
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
❑ Gas Factory Fireplace
❑ Wood Burning Fireplace
❑ Wood Stove
❑ Wood Stove With Flue
Brand Name: Model No.:
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations ��
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHALL)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
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�
'PERl�iIT FEE CALCULATION(S) .
BASED OFF - 2002 STATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1. Does not require modificarion to electrical or gas service.
2. Has a total cost of$500.00 or less;excludino the cost of the fixture or appliance: and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Pemut $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $
i PERMIT FEE CALCULATION(S)—JOBS OVER-$500.00.` "+�
If above does not apply; follow guidelines below:
l. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00)
� �
�� ,Io�T)O �— x.0125 $
(contract price) (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x .0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications} $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Abovej $
• * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
pemutted work including materials, labor,profit, and other fixed costs. It is the amount to be charged
to the customer for the work done. If any material, equipment, labor or installations are fiu-nished 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 pernut 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 Building Department at(952) 249-4600 for the price.
MECHANICAL PERMIT APPLTCATIO�AGREEMENT ; ,,,,,,,�'.�,
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 the State of
Minnesota, and certifies that all statements made on this application are complete, true and
correct.
Applicant's Signature: Date:
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