HomeMy WebLinkAbout2005-09370 - mechanical PERMIT
CITY OF ORONO
Permit Number:
2750 KeIIE°�,� Parkway- PO Box 66 Po937o
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4C00 Date Issued: l0/28/2005
SITE ADDRESS: 1160 Heritage La Unit#
Wayzata,MN 55391
PID: 10-117-23-13-0003
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Mechanical Permits Permit Sub-type(s): Multiple Mechanical Items
DETAILS:
Approved perresolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 161.25 valuation: $ 12,900.00
State Surcharge Fee: $ 6.45
Misc. Fee: $ 1.50
TOTAL FEE: $ 169.20
APPLICANT: Golden Valley Heating&Air(See Comme OWNER: Erwin&Sandra Bullock
5182 West Broadway 1160 Heritage La
Crystal,MN 55429 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
�f lc-�-c.-� Gr��
APPLICANT PERMITEE SIGNATURE SUED BY SIGNATURE
Copies: 1-File(SignaturesReguired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, 1-Septic) Page 1
!"'
FOR C1TY USE ONLY
: � , � 4�� City of Orono
P.O.Box 66 Date Received: Permit#
�r S 1 ��,;,,,,Y � 2750 Kelley Park�+�ay
'`'��<`'' Cr stal Ba MN 55323 Approved By: Amount�:
� 11`� �: �- �' Y Y�
�'� �i��-�'�;�.o` (952)249-4600
�$,h;;, �.
eKoB
CITY OF ORONO —MECHANICAL PERMIT
(All Commercial pennits must Ue approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL 1NFORMATION
1. You may apply for mechanical pernuts by mail or in person at the City offices. Applications will
be reviewed and a permit will be issued within two working days.
2. Pernut cards will be sent by retuin mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERiV1IT. WORK MUST NOT BEGIN UNTIL TAE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desi�ns—Complete calculations, details aiid specifications are required for each
heating, ventilation, humidification-dehunudification, 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 p:ovided.
4. When any new consri-uction or remodeling is involved, a separate building peinut 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 fival). 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 ❑ Coirunercial(Approval Required)
❑ New ❑ Additional ❑ Repairs ❑ Replace
Job Site/ Owner Information:
Site Address: � �1�� ��✓
,
Owner: // ,�,��/C,�.i Mailing Address:
City: l/ �-U/V(� Zip: .-;�=;�: �,
JJJ�
Home Phone: � � �"� "���� �� 1' Alternate Phone:
Contractor Information:
Contractor: Contact Person: ' '� "
Address: State Bond#:
City: Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance—Current:
1
''�►
MECHANICAL SYSTEMS BEING INSTALLED ` ,
�` � .
w
HEATII�TG SYSTEMS ``
Quantity: J
Make: " ` ��J�
Model: � Q �.(� � J
Fuel: ��
Flue Size: �
Input BTUs �� � (��J'J
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity: �
Make: Lv�' I r lOX
Model: 'J���C��
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 cfm
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:
2
r
, � '
• _ ' PERMIT FEE CALCULATION(S)
' BASED OFF - 2002 STATE STATLTE
❑ Yes, this section applies
The replacement of a Residential fixture or appliance that meets all tluee of the following requirements:
1. Does not require modification to electrical or gas seivice.
2. Has a total cost of$500.00 or less;excluding the cost of the fixture or appliance: and
3. Is improved,installed or replaced by the homeowner ar licensed conh�actor.
Skip next section, if this applies; Cost of Pernut $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $
i PERNIIT FEE CALCL?LATION(S)—JOBS OVER$500.00 �,
If above does not a�ply; follow guidelines below:
1. CONTRACT PRICE * is 1.25% of contract price with a(Minimum Fee of$35.0�
� �� �� x.0125 $ ! �,O ' � �
(co t act 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 Above) $
� � t1 � V
■ * 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 furnished by
the ov�nier, tenant or any other party, the reasonable market value of such items must be added to the
eSt1ri13Ted COST OT CO11tT'aCt pT1Ce IOI PCIITllI i�Z j7U1"�u�C�. iii the ever�t i�I3t ii1CiC iS S u15j�Ute OII .i1C
amount of the job cost, the City may request the submission of a signed copy of the actual conhact.
■ **The STATE SURCHARGE is .0005 of the Building Department at(952)249-4600 for the price.
MECHANICAL PERMIT APPLICATION 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
conect.
�pplicaiit's Signature: �-����✓4�- l Date: OCT � � �DD� _
/
3