HomeMy WebLinkAbout2003-P07061 - mechanical y � PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po�o6t
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued: i2�a�2oo3
SITE ADDRESS: 4125 Highwood Rd
Mound,MN 55364
P��: 07-117-23-44-0084
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Mechanical Permits Permit Sub-type(s): Multiple Mechanical Items
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernlit Fee: $ 250.00 Valuation: $ 20,000.00
State Surcharge Fee: $ 10.00
TOTAL FEE: $ 260.00
APPLICANT: Upper Midwest Radiant OWNER: John&Roberta Henrich
5115 Industrial Street 4125 Highwood Rd
Maple Plain,MN 55359 Mound MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT � RMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Annlicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT
Box 66 (2 750 Ke11ey Parkway)
Crystal Bay, MN 55323
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 RECENE A PERMIT. WORK MUST NOT BEG1N UNTIL THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Mechanical Desi r�is-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. Identification of and specifications for water heating
equipment shall also be provided.
4. When any new construction or remodeling is involved, a separate building pernut 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-hour notice required.
7. House Heating Test Record must be submitted before final.
Instructions
Complete all items on this application. Compute the permit fee. Sign and date the certification.
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call
(952) 249-4600.
Please check one: [�New ❑ Addition ❑ Repair ❑ Replace ❑ Residential ❑ Commercial
JOB SITE: �� " i � , ., �� Zip: l J :'�l!`f
Owner's Name: j ah i�_ - c 4�_ Phone Number: 7�3 � y 7��- 3� ,� �
Mailing Address: 4� ;}5�};G �,r�,r�( �;�,� City: r�.-��1� Zip: ��, :3(o�
L��DQ,r I ►'11��Sr �GL[L� CirL�
Contractor's Name: �=T i. � ' - '- T�- -, phone Number: 7�'3 �7�J ` (3�S'
Mailing Address: �;��5 =LrtcLcc 5�'r�a/ S-t- City: ) y����(F ���ti Zip: �� :=����j
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PERMIT FEE CALCULATION(S)
2002 State Statute ❑ Yes This Section Applies
The replacement of a Residential fixture or appliance that meets all 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; excludin�the cost of the fixture or appliance:
and
3) Is improved, installed or replaced by the homeowner or licensed contractor.
Skip next section; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee $ 1.50
If above does not apply, follow guidelines below:
1. Contract Price* is .0125% of job with a Minimum Fee of($35.00)
� ,;1c". c� (`.(_`�o x .0125 $
(contract price) (minimum$35.00)
2. State Surchar�e. ** Add the State Building Code Division a Minimum Fee of($ .50)
x .0005 $
(contract price) (minimum$.50)
3. Postage and HandlinE (O�:ly mai!-in applications) $ 1.50
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 installation is fumished 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 of the contract price under$1,000,000 or$.50-whichever is greatec For valuations over
$1,000,000 call the Department of Inspectional Services for the price.
T'he 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 Minnesota State Building Code,and certifies that all statements made on this
application are complete,true and correct.
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Applicant's Signature: -�c�� �� � %���'-� �{_ , Date: �� G;
Approved By: Date:
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SYSTEM DESCRIPTION -
HEATING SYSTEMS
Quantity: � �
Make: �.-.c u�e�'s�c���_ ���t� ��ct: r:
Model: C_x V�'Y1 �j -0�'t����%i �b 5(o V✓
Fuel: �(c� (�ctS t-1 r[� fr�c',
Flue Size: ��� �y�C� —
Input BTCJs: ���Qf�O C�Ci
Output BTCTs: ,�/ C;
CFM: � �–
COOLING SYSTEMS
Quantity:
Make:
ModeL• � � L��, �
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Tons: /
H.Power j. �
FIREPLACES GAS LINE O\LY
�l Gas factory fireplace ���u�"-,�;- (_,.��, (-�;�,�;r�%(�c,�<. � Installing a Gas Line Only
❑ Wood burning factory fireplace with flue
❑ Wood Stove
�I Wood stove with flue �,�� r rr�r r�.:E C:�;�+-i rt J� �.;t_��c.c c:T�C�
Brand Name Model I�To.
VENTILATION
No. Kitchen Exhaust x duct recalcularing _�=G cfin
No. �-�- Bath Exhaust(must have duct outside) �cfm
No. C, Other Fans: Locations cfm
FUEL STORAGE (MUST BE APPROVED BY FIRE�L�RSHAL)
❑ Installation or ❑ Removal .
❑ Fuel oil: gallons ❑ underground ❑ inside ❑outside
❑ LP Gas: gallons
❑ Other Gas opening
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