HomeMy WebLinkAbout2002-P05709 - mechanical CI�Y �F ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Pos�o9
Crystal Bay, Minnesota 55323 Pet'mit Type: Mechanical Permits
(952) 249-4600 Date Issued: io�si2oo2
SITE ADDRESS: 259 Hollander Rd
Wayzata,MN 55391
PID: 25-118-23-43-0017
DESCRIPTION:
Proposed Use: Residential
Pernut Class: General
Permit Type: Mechanical Permits Pernut Sub-type(s): Multiple Mechanical Items
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 93.75 Valuation: $ 7,500.00
State Surcharge Fee: $ 3.75
Misc. Fee: $ 1.50
TOTAL FEE: $ 99.00
APPLICANT: Superior Contractors Inc. OWNER: Tony&Mary Becker
6121 42nd Ave N 259 Hollander Rd
Crystal,MN 55422 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.
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APPLICANT PERMITEE SIGNATURE ISS� BY SIGNATURE
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Copies: 1-File(SiQnitures Required), 1-Apnlicant, 1-Monthlv Renorts, 1-Assessin�, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
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GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be
reviewed and a pernut 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 BEGIN UNTIL THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Mechanical Desi ns -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 permit must be obtained.
5. All wark 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: .�.5� J�L.L!�.� --� �-D Zip: �S3`�I"
Owner's Name: T'oN•; ��c��� Phone Number: q.s,� - ��q _ ���y
1�Tailing Address: Si}-��� City: Zip•
Contractor's Name: S,�c���,� �'�,,✓T,eq��s ,NtPhone Number: ���- S�7—�'�4j
Mailing Address: (�1,�� ��.� ,q-�� ti'. City• C'_�E'�=S`�-` Zip• .��tf��
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SYSTEI�1 DESCRIPTION
HEATING SYSTEMS
Quantity: �
Make: C��l``�'
Model: ��!'i V'p!�
Fuel: N1� G A�5
Flue Size: �a�� �v e
Input BTUs: � � [rE�u
Output BTUs: 1�3 0��
cF��: 1��,�
COOLING SYSTEMS
Quantity: '
Make: ��"'E'���l"
Model: ���j-'�CA-fi��
Tons:
H.Power
FIREPLACES GAS LINE ONLY
❑ Gas factory fireplace ❑ Installing a Gas Line Only
❑ Wood burning factory fireplace with flue
❑ Wood Stove
❑ Wood stove with flue
Brand Name Model No.
VENTILATION
No. Kitchen Exhaust duct recalculating cfm
No. Bath Exhaust(must have duct outside) cfm
No. Other Fans: Locations cfm
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
❑ Installation or ❑ Removal
❑ Fuel oil: gallons ❑ underground ❑ inside ❑outside
❑ LP Gas: gallons
❑ Other Gas opening
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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)
�.��� X .olzs $ 93. ��s
(contract price) (minimum$35.00)
2. State Surcharge. ** Add the State Building Code Division a Minimum Fee of($ .50)
�5Z"vc1 x .0005 $ 3 '7�
(contract price) (minimum$.50)
3. Posta�e and Handlin� (Only mail-i�: applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ �7•f=��
*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 oamer,±enant or any other party the reasonable market va'.ue 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 greater.For valuations over
$1,000,000 call the Department of[nspectional Services for the price.
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 regula' ns of the Minnesota State Building Code,and certifies that all statements made on this
application are complete,true and co ect.
Applicant's Signature: �-^' - Date: /�,-�7-C.;1
Approved By: Date:
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HOUSE HEATING TEST RECORD
ADDRESS � � r APT. FLOOR CITY SUBURB ��� ,
OCCUPANT T OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY �C�- INSULLED BY_«��L.u�s^r-
El�ctrieol Wo►k Bp ��"� Gas Lin� Br �
TYPE OF HEAT GA FA�HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE ��°� MAKE OF BURNER
�d.1 Sfr.,L��r� i�v—F—/Gi� �„�,d.i
s«to� 3 7�� �/��`/� �x. BTU Rotiny
INPUT ����d MAKE OF FURNACE
Modsl
CONTROI.S i�
THERMOSTAT ��� H�at Pluy —� V�nt Siz� 3
Valw �/t KIND OF LINER SIZE NONE �
Limit �!Z Drah Hood R�pulowr
Limit S�ttiny � FI It�rs Sis� �G�' +'�` ��umb�r '
Fan S�ttiny Chim��y Location Insid� � Outsid�
Pilor Trp� s�-L- Chimnsr Construetion ��✓�—
Pilot Mok� tf�
Pilot Mod�l Smok� Bomb Wiriny _
Pilot Timin� �-�`� D►aft ��-� T�st Tap
L.W. Cut Off Dow Pr�ssur� Liyhfiny i�st.
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Pr�ssun � s P�rc�ot COZ—,C— Da» T�st�d l - ��r
Input CFH ¢a� P�rc�nt 0� '-� Company Testing
Stoek T�mp. ��a'� P�runt CO Nam�of Test�r
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