HomeMy WebLinkAbout2012-00785 - mecahnical CITY OF ORONO * z � 1 z - 0 0 7 8 5 *
2750 KELLEY PARKWAY DATE ISSUED: 08/14/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1035 HERITAGE LA
PIN : 10-117-23-13-0009
LEGAL DESC : FOXHILL
: LOT 003 BLOCK 002
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL- MULTIPLE
VALUATION : $ 6,000.00
NOTE: (I)BRYANT HEA"I'ING SSYSTEM
MODEL-386TA-NATURAL GAS-2" PVC-80,000 INPUT,78,000 OUTPUT BTU'S- 1600 CI'MS
(1)BRYANT COOL]NG SYSTEM-MODEL 126E3NA-2.5 TONS-25 AMP
APPLICANT MECHANICAL 75.00
COUNTRYS[DE HEATING&COOLING STATE SURCHARGE MECH (VALUATION) 3.00
651 I HWY 12 TOTAL 78.00
MAPLE PLAIN, MN 55359
(763)479-1600 PAID WITH CC# 1067
OWNER
FRITZ,JEFF& ELLEN
]035 HERITAGE LA
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The���ork for���hich 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 the work described and does
not gran[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]80 days at any time after work has commenced.
The applicant is responsibie for assuring all required inspections are
requested n conformance ith the State Building Code.This permit may be
revokedfat ny time fo d c se.
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Applicant Permitee Signature Date Issu B Si nature Date
Y� �
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
F om:�UNTRYSIDE HEATING & COOLING 763 479 2518 08/13/2012 11 :42 #571 P.001/003
F CI Y USE ONLY
'��- City of Orono �/ /�,
����� Date Receivc : / �� Pcnnit k O�U� �' ���
P.O.Box 66
!�O. � 2750 Ke[ley Parkway c �
\ �,`lf,v :. �� Crystal Bay,MN 55323 Approved By: Amount$��O . f
\��f���3���� Phone(952)249-4600 Fax(932)249-4616 �' ��
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CTTY OF ORONO-MECHA.NICAL PERMIT �v�-
(All Commercial permils must be approved hy the Building Official or lnspector andlor fire MarshalJ)
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will
be reviewed and a perznit will be issued within two working days,
2. Permit cards will be sent by rttam mail after a rcvicw is completcd. PERMTTS ARE NOT
VALID UNTTL YOU RECEIVE A PERMIT. WORK MUST NOT�EGIN UNT1L TI3E
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desiens—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,equipznent ratings and identification as to
type,manufacturer and model. Data shall be presented on form provided.
4. When any new construction or remodeling is involved,a separate building pecmit 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(952)249-4600.
(24-48 hour notice required)
7. Housc Hcating Test Record must be submitted before final.
TYPE OF PERMIT
Check All That A 1
�Residential ❑Commercial(Approval Required)
❑New ❑Additional ❑Repairs ❑Replace
Job Site/Owner Information:
Site Address: ��•� /��i`f f iK�. �A�-�--
Owner: �� ����- Mailing Address: ������`l�1 ��-
City: � v1�O Zip: ���� �
Home Phone:((O�a 1 a �7r�3 y9 Alternate Phone:
Contractor Information:
Contractor: ����'1f�j� �1 F�'I�l� Contact Person: �/�hc.�A(l%Gl � Q ��Twyrl.
V /y�p�
Address: ��� w �� State Bond#: !'l 1� U���.3
Ci �L�? /��1 h Zip:JrJ'r3�9 Expiration Date: 6�� ���.-��y
tY; �
Phone: Alternate Phone:
❑ Insurance-Current: I � '�e' �D016 �'�
1 Il�l,�e�vz�l��e ����
F jo�m:�NTRYSIDE HEATING & COOLING 763 479 2518 08/13/2012 11 :43 #571 P.002/003
MECHANICAL SYSTEMS BEING INSTALLED
Note: Al] Geothermal Systems wiI] now require a Site Plan& Review by our Building Official.
IS THIS GEOTHERMAL? ❑ Yes �No
i�EAT1NG S1'STEMS
Quantity: �-------- --- -�------ ------------•-- --
Make: � �- ^^� _ _
r �V/ --
Model: ��b ��_ _ _ _ w
Fuel: ___�_,u� - - ---_-_-
Flue Sizc: �PvC-
Input B'Tt)s: �� . ..__-- ---------
�
Output B7'Us, ��� ___.____._ _.__._.._.�_
CFM: ,1,� ��
COOLI1�iG SYSTEMS
Quantity: J-
Nlake:
Model: (O��U 8��.
Tons: 01 ` �
H. Powcr o����`_p._ �__
FIREPLACES
❑ Gas Factory Fireplace Brand Name: ___��„_____________
❑ Wood Burning Fireplace
❑ Wood Stove Mode]No.: _
❑ Wood Stovc with Flue/Masonry
VENTILATION
❑ No. Kitchcn Exhaust duct recirculating cfm
❑ No, J_ Bath Exhaust(must have duct outside) __^__cfm
❑ No. Other Fans: Locations_ ____._, cfm
FUEL STORAGE (Must be approved by Fire Marshall if proposing lo aba�idon tarrk in place.)
❑ Installation ❑ Removal
Fue] Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: __�gallons
Other:
GAS LINE ONLY
❑ Outdoor Grlll ❑ Other/List V✓hat&Where:___ _
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F��o�m:�l1NTRYSIDE HEATING & COOLING 763 479 2518 08/13/2012 11 :43 #571 P.003/003
PERMIT FEE CALCULATION(S)
BASED OFF - 2UOZ STATE STATUE
❑ Yes,this section applies
"The replaccmcnt of a Residential fixture or anDliance that meets aU 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;excludinQ the cost of the fixturc or appliancc: and
3. Is improved,insta]led or rcplaced by the homeowner or licensed contractor_
Skip next section,ifthis applies; Cost ofPermit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee S
PERMIT FEE CALCULAT'ION S —JOBS OVER$500.00
If above does not apply; follow guidelines below:
1. CONTRACT PRICF: * is 1.25%of contract price with a(Minimum Fee of$50.00)
6D oD. �,o x .o�2s $ 73: o�
(contract pnce) (minimum SSO.DO)
2. STATE SURCHARGE
�o OD _ oo_�_x .000s $,.____._�____._.,�----------
(contract pricc)M
3. POSTAGE&HANDLING(Only on Mail-ln Applications) � 9�d
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S �g . ��
• * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials, labor,profit, and ocher fixed costs. It is the amount to be charged
to the cuscomer for the work done. If any material, equipmen�, labor or instaltations arc furnished by
the owner, tenant or any othcr party, thc reasonabie market value of such items must be added fo the
cstimated 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 may request the submission of a signed copy of the actual contract.
MECHANICAL PERMIT APPI.iCATION AGREEMENT '
The undersigned hereby applies to the City for issuance of a Mechanica] 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 com,plete, true and
correct_
Applicant's Signature: v v Date: � ��3 ' �o"—
?63 -y1g , l�D�o
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