HomeMy WebLinkAbout2017-00119 - mechanical � CITY OF ORONO * z 0 1 7 - 0 0 1 1 9 *
� 2750 KELLEY PARKWAY DATE ISSUED: 02/09/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 195 CRYSTAL CREEK RD
PIN : 33-118-23-32-0004
LEGAL DESC : CRYSTAL CREEK
: LOT 007 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 1,040.30
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
REPLACE: 1 HEATING SYSTEM(PAYNE)
APPLICANT MECHAN[CAL 50.00
STATE SURCHARGE MECH(VALUATION) 0.52
BWS PLUMB[NG,HEATING&AIR MA[L-[N FEE 2.00
7251 WASHINGTON AVE S
EDINA, MN 55435- TOTAL 52.52
(952)715-0979 Payment(s)
CHECK 3547 52.52
OWNER
JUDGE, BARRY
195 CRYSTAL CREEK RD
LONG LAKE, MN 55356-
AGREEMENT AND SWORIY STATEMEIVT
The work for which this permit is issued shall be perfonned 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 grant 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 l80 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause. � �
-, �,:�
�� � � % -
__
��:"� f � ��; j 1� ����.�.-> �,��,� r ���� ..:� � �f , i �
Applicant Permitee Signature �^ Date Issued By Signature Date
FOR CITY USE ONLY
' �� � _ City of Orono ��',-� ��Z��;/ 7�- �: ;���:
��/ P.O.Box 66 Date Received: �.� %i/ �Permit# �
O � 2750 Kelley Parkway ''� � �— :y._
�� Crystai Bay,MN 55323 Appmved By: � i Amount$: �„< <
� �� Phone(952)249-4600 Fax(9521249-4616
� ^ ;
,
�y� " � CITY OF ORONO—MECHANICAL PERMIT
.
�k�s���� (Ail Commercial permits must be approved by the Building Official ar Inspector and/or Fire Marshall)
�——'
GENERAL INFORMATION �
L 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��ithin 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 NO�T BEG[N 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 condirioning installation including
heat loss/heat gain calculation,design temperatures,equipment ratings and identification as t��
type,manufacturer and model. Data shal�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 Apply)
�Residential ❑Commercial(Approval Required) [Backflow Device: ❑AVB ❑PVB]
❑ New ❑Additional ❑Repairs �Replace
Job Site/Owner Information: �
Site Address: � q 5 C vv� S tZt� t►%�1�: �'..�-�
Owner: , a��,� �,,6Qc�� Mailing Address:
City: �'rc�n G Zip: 5_`� 3=� �
Home Phone: ��Z '��8� ( � �� Alternate Phone:
Contractor Information: �
Contractor: �'���'l0 � �1/{�(, Contact Person: �rv'�� S't"I�Gnd �v�j
✓
Address: 7 Z� I W ab1��n�t�� '�L State Bond#:
City: ���v�,(1� Zip:�� Expiration Date:
Phone: (�1���7 I, ��� ?� Alternate Phone: ��5�� �C�7' �sy Z
❑ Insurance—Current:
1
. ':MECHATIICAL SY4'TEMS BEt�C Tl�i�aTAI,LED`
Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes �No
REATING SYSTEMS
Quautity: �
Make: �
Model: �C7��GS�o/�� G
Fuel: �C/G/�A'G�� �Gc,S�
Flue Size:
6 �i
Input BTUs: /00, �GO
Output BTLTs: �`dd
CFM: �� D�
COOLIlVG SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen Eachaust duct recirculating cfin
❑ No. Bath Exhaust(must have duct outside) cfin
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in plac�)
❑ Installarion ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
PERI�T:��CALCLJLATI�03�fiS `
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
�d�U 3D x.0125$—��� oC�
(contract price) (minimum$50.00)
2. STATE SURCHARGE /� ,/D �D , ��
�� x.0005 $
(conhact price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
�2 ��
■ * 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 pernut fee pwposes. 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.
ME�HANTC,hL P�RARIT APPLI�A�`I1J►`�+I�.�REEiI'��'I'
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 ma on this apn]ication complete,true and correct.
�% 'l
� �'
Applicant's Signatur • Date: Z�� � ��
3