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Home My WebLink About2011-01350 - mechanical CITY OF ORONO PERMIT NO.: 2011-01350 .., 2750 KELLEY PARKWAY . ORONO, MN 55356- DATE ISSUED: 10/28/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 3405 HIGH LA PIN : OS-117-23-11-0002 LEGAL DESC : REG. LAND SURVEY NO. 0843 : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : MECHANICAL-MULTIPLE VALUATION : $ 1,000.00 NOTE: 1 KITCHEN EXHAUST GAS LINE TO RELOCATE STOVE APPLICANT MECHANICAL 50.00 FLARE HEATING&AIR COND STATE SURCHARGE MECH(VALUATION) 0.50 9309 PLYMOUTH AVE N SUITE 104 MAIL-IN FEE 6.50 GOLDEN VALLEY, MN 55427 MISC FEE (763)542-1166 TOTAL 57.00 OWNER REILLY, KEVIN& DENISE 3405 HIGH LA LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT 1'he work for which this permit is issued shall be pertormed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permi[is for only the work described and does no[grant pennission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming 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 180 days at any time atter work has commenced. 'Che applicant is responsible for assuring all required inspections are requested in conformance wi[h[he State Building Code.This permit may be revoked at any time for�ue cause. l�%V��r �, �� / / l l v-ai�.G Applicant Permitee Signature Date Issued By Si ature e SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED ABO . ��-�� FOR CITY USE ONLY ' �` City of Orono � �,•� `g�0�i`�, --... � \ P.O.Box 66 Date Received: Permit# � f�� `� � �� 2750 Kelley Parkway �`:;;�'" I� � }ty� � Crystal Bay,MN 55323 Approved By: Amount$: ` ��,�.{r`o�,/�� Phone(952)249-4600 Eax(952)249-4616 �`..��,� oa�. ____:,::� CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits must be approved by ihe Building Official or Inspector and/or Fire Mashall) GENERAL INFORMATION 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 two working days. 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN U1vTIL 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. 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(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 1 �esidential ❑ Commercial(Approval Required) / ❑ New ❑Additional �epairs ❑ Replace Job Site /Owner Information: Site Address: ��C�j ��G'r� �G.v�� . �4'l�Y'�O �cJ•��L� Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: �C�.v�. �?s��,h�� <� .�l (� Contact Person: �,� ��r�rvzr� . Address: C��j �\u��,�,��-;r� .�1� State Bond#: City: �� ! 1 e; Zip:��Z� Expiration Date: Phone: ��p� - �`7L�2-\�� Alternate Phone: ❑ Insurance—Current: 1 MECHANICAL SYSTEMS BEING INSTALLED � Note: All Geothermal Systems will now require a Site Plan & Review by our Building Official. IS THIS GEOTHERMAL? ❑ Yes�No HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: Input BTUs: Output BTUs: CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: H. Power FIREPLACES Gas Factory Fireplace Brand Name: Wood Burning Fireplace Wood Stove Model No.: Wood Stove With Flue VENTILATION No. �_ Kitchen Exhaust_�(�duct recirculating �cfin No. Bath Exhaust(must have duct outside) cfm No. Other Fans: Locations cfin FUEL STORAGE (Must be approved by Fire Marshal!ijproposing to abandon fank in place.) � Installation � Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside LP Gas: gallons Other: GAS LINE ONLY � Outdoor Grill � Other/List What&VJhere: re��(;��z �� tv�_ 2 3 � PERMIT FEE CALCULATION(S) � � � BASED OFF - 2002 STATE STATUE ❑ Yes,this section applies The replacement of a Residential fixture or a�pliance that meets all three of the following requirements: l. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less;excludine 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 $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ PERMIT FEE CALCULATION(S)-JOBS OVER$500.00 [f above does not apply; follow guidelines below: 1. CONTRACT PR[CE * is 1.25%of contract price with a(Minimum Fee of$50.00) ��; IC�(�CJ�,� x .0125 $ 5� (contract price) (minimum$50.00) 2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of$5.00) ��.! �,.. X .000s $ .-r�. -- (contract price) (minimum$5.00) 3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 2.00 �<� 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 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 may request the submission of a signed copy of the actual contract. ■ ** The STATE SURCHARGE is .0005 times the Contract Price or a minimum of$5.00. 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 correct. / __. Applicant's Signature: 'L� Date: /� rZ� -1 � Reset Form 3 � �!'� � � � DATE TIME �CITY OF ORONO ca��Eo w ' �D'� ' YY� INSPECTION NOTI E SCHEDULED �_9�� ' PERMIT NO. �JO COMPLETED ADDRESS � ��'�% � LfC;%'�. � /� OWNER TELEPHONE NO.��S�a`'�1�� CONTRACTOR Cl__I')G�I L1 l'�/��I�il.�Y ��.Q.�l� � ��- , � >; DESCRIPTION ' � ��( t// 7C /r � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING �MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEP IC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W � j d W� ❑WORK SATISFACTORY:PROCEED �}•'PROJECT COMPLETE W ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY O ❑CI�RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. G PHOTO TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (J52� 249-46�� Owner/Contractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice