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Home My WebLink About2012-00219 - gas line only f CITY OF ORONO * 2 0 1 2 - B 0 z 1 9 * " 2750 KELLEY PARKWAY DATE ISSUED: 03/23/2012 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 3380 GRAHAM HILL RD PIN : OS-117-23-11-0013 LEGAL DESC : GRAHAM HILL PRESERVE 2 : LOT 5 BLOCK 2 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY VALUATION : $ 425.00 NOTE: GAS LINE TO GENERA�'OR APPL[CANT MECHANICAL 50.00 HEAT[NG& COOLING TWO INC. STATE SURCHARGE MECH (VALUATION) 0.21 18550 COUNTY ROAD 8] MAPLE GROVE, MN 55369- TOTAL 50.21 (763)428-3677 OWNER RUDOW, DAVID& LESLIE 3380 GRAHAM HILL RD ORONO, MN 5535Er AGREEMENT AND SWORN STATEMENT The work for which this permi[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 compicd with whether or not specitied herein.This permit will expire and become null and void if construction authorized is not conunenced within I 80 days of the date of issuance,or if construcCion is suspended for a period of 180 days at any time after work has commenced. "i'he applicant is responsible for assuring all required inspections are requested in conforniance with the State Building Code.This permit may be revoked at any[ime for due use. �� lG�l / li — � l l Applic rmitee Signature Date [ssued By S' ature te SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV . � City of Orono � � �� FOR CL-TY U9��ONLY �� r . i Q o P.O.Box 66 ��:, 2750 Kelley Parkway Date Received: Permit# r 1�i`�� ,�'�" �,'' C�ystal BaY,MN 5�323 --- t�l`��1��` (952)249-4600 Approved By Amount$: ,;..-� CITY OF ORONO —MECHANICAL P� y (All Conlmercial perr,iits mwt oe apDroved by(he Building Official or Inspecto�d ZT��e�qarshall) GENERAL I��'O�ATION I. You may apply for mechanical peimits by mail or in person at the City offices. A be reviewed and a permit will be issued within rivo working days. PPiications will 2. Permit cards will be sent by retui-n mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECENE A PERMI'I', WORK MUST NOT BEGIN UNTIL THE �E��I I'CARD IS POSTED ON THE JOB SITE. 3� Mechanical Desi nc_ Complete calculations, details and specifications are requued for each lieating, ventilation, hunudification-dehumidification, and air conditioning installation inclu ' heat loss/heat gain calculation, design temperatures, equipment ratings and identification as t�ong type, manufacturer and model. Data shall be presented on fornz provided. 4• When any new conshuction or remodeling is involved,a separate buildulg pe�t must be obtained. 5• All work 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 Apply) �Residential ❑ Commercial A ( pproval Required) ❑ New ❑Additional ❑ Repairs ❑ Replace Job Sife/ Owner Information: Site Address: �3 � . Owner: Mailing Address City: Zip: Home Phone: Alternate Phone: :Contractor Information: Contractor: H O lNC. Contact Person: Address: 18550 County Rd. 81 MsR rove MN 55369-9231 State Bond #: (763) 42 - 7— City: www.heatcooi2,com Zlp: Expiration Date: Phone: Alternate Phone: ❑ I�Isurance— Current: , , � ��c�rlcaz.sYsT��z3s BEnvG r�TsT��Lr rl� � — L u�,� � ��, - = z HEATING SYSTEII�IS Quantity: vlake: Model: FueL Flue Size: Input BTUs: Output BTUs: CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: H. Power FIREPLACES ❑ Gas Factory Fireplace ❑ �Vood Burnind Fircplace ❑ Wood Stove ❑ Wood Stove With Flue Brand Name: ------_. Model No.: VENTILATION ❑ No. ______ �tchen Exhaust ❑❑ No. ___.____ Bath E�chaust(must ha ev d cu t�outside recirculating �� No. ___ Other Fans: Locations cfm FUEL STORpGE (MUST BE APPROVED BY FIRE MARSHALL) cfm ❑ Installation ❑ Removal Fuel Oil: �_gallons LP Gas: ___�allons � Underground � Inside ❑ Outside O ther: GAS LINE ONLy ❑ Outdoor Grill ❑ Other/List What &Wh� 2 PE��LI�I' R;CE CilLCULATlOi�(S - Bf�SED OFF - 2002 ST.�TE ST1�T.IJE - '� ❑ Yes, diis section applies The replacement of a Residential fixture or a liance 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; excl_ udin� 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 Permit $ 15.00 State Surcharge $ .SO Mail-In Fee(If Applicablej $ 1.50 Total Permit Fee � �r, `�k� � p'� , �EERi'VIIT�FE�CALCT�L"�A,. IO�T(S��'-��'�`OB-��p,V�R��50b Ob�'��.` � �"� � �� , _ - � . .. �-- � - �•;� s._� If above does not apply; follow guidelines below: I. CONTRAC"I'pR�CE *is 1.25%0 of contract price with a(Minimum Fee of$35.00) �. �L �� 'L` �i x _p125� (contract price) (minimum 53�.00) � �. �1':�'1'�; SURCiI1...R�E * * Add the Jtate Blrl�* C'nriP �h.; �,,;Ch7:�e (.l�liai:7;u�i Fec ui�.�0) ----____ x .0005 $ �co,..,...,;r�� r.., - --. 3, i OSTAGE & HANDLING (Onl}�on �2ail-In Aprlic�r_;cii;) � ��'��'� ��; I.50 4. TOTAL PEI2�VIIT FEE (Add Lines 1-3 Above) � ' * CONT'IZqC'T pRICE or JOB COST means the actual or esrimated dollar amount charged for the permitted work including materials, iabor,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 furnished 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 permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City rnay request the submission of a signed copy of the actual conttact. ' ** The STATE SURCHARGE is .0005 of the Building Deparnnent at(952) 249=4600 for the price. -�°,k — �..� =rs'=� CHA�C�PE ,�,?�I, � � �_ ��.: �._itiiE � � R�II`T�" � �::'T�I'0�;��`'�R�ETt�E'I�� s 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 ity and the regulations of the State of Minnesota, and certifies that all state this application are complete, true and correct. ade � . � i� Applicant's Sib ature: ,f. ,..-� 2 � � . Date: � —� ./' i � 3 � DATE TIME ✓ CITY OF ORONO cA� INSPECTION NOTICE a/ SCHEDULED __,��`ttF�--�C� 'ERMIT NO. COM�LETED ADDRESS 3 � �� "�-`'"I Q'� c ' L`J OWNER TEL HQNE NO.?��—`�-��77 CONTRACTOR � � DESCRIPTION � � f- - "' � � l� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ IAKESHORE/WETLANDS � O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB � WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W � � , GW �"E�-WpRKSATISFACTORY:PROCEED PROJECTCOMPLETE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ��CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on site: Inspector. White Copylinspector's File Canary CopylSite Notice