HomeMy WebLinkAbout2012-00813 - gas line only > • CITY OF ORONO * z 0 1 2 — 0 0 e 1 3 *
2750 KELLEY PARKWAY DATE ISSUED: 08/17/2012
ORONO, MN 55356-
(952)249-4600 FAX: (952)249-4616
� ADDRESS : 3532 IVY PL
�
; PIN : 20-117-23-42-0033
� LEGAL DESC : TAYLORS SUBD OF SPRING PARK LO
: LOT 000 BLOCK 000
� PERMIT TYPE : MECHANICAL(>$500)
+ PROPERTY TYPE : RESIDENTIAL
� CONSTRUCTION TYPE : GAS LINE ONLY
� VALUATION : $ 795.00
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` NOTE: GAS LINE TO OUTDOOR GRILL
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'• APPLICANT �CHANICAL 50.00
, WESTONKA MECHANICAL INC STATE SURCHARGE MECH(VALUATION) 0.40
�_ 6501 COLJNTY RD 15
VIOUND,MN 55364 TOTAL 50.40
i (952)472-4966
OWNER
'AUL,PAUL&JULIE
" 3532 IVY PL
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
, The work for which this permit is issued shall be performed 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 speci£ed 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 after work has commenced.
Y 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 due cause.
1 i 1 / / � / ��, / /
A p tcant Permite ignature Date Issued By Sign ure Date
,. SEPARATE PERMITS REQUIRED FOR WORK OTHER T AN DESCRIBED ABOVE.
� �
f � ' FOR CI�'1'd1S�`�FT�`'S( =
�,¢0�� City of Orono a: � -
P.O.Box 66 T�a#�Aeces�ve�3 �;Perahtt�-
2750 Kelley Parkway `
� � ;� :� � Crystal Bay,MN 55323 Appraued$q ��Amuunt$
�y Phone(952)249-4600 Fax(952)249-4616
CITY OF ORONO-MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
GE�tERAL INFO�tI1%IA�TfJN F'
1. You may apply for mechanical pemuts 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 UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Designs—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air condirioning installarion including
heat loss/heat gain calcularion,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.
'T��(���?ER�T
<C�e��-A�"=T�at�. `� �;
,�]Residential ❑Commercial(Approval Required)
❑ New ❑Additional ❑Repairs ❑Replace
7�b S���rl��vri�r�`�rma.�io�
Site Address: 3 S3� ��y / L �L C�
Owner: �'o� ✓�� +�� pu�n � Mailing Address:
City: �rd� O Zip:
Home Phone: �IS2� g23- /� SS Alternate Phone:
�o�tr�a�i�r.T�c�rmat�on;
Contractor:�e�on � h�1-ecJ�n Gd� ContactPerson:
Address: �OSo� (�c� ( � State Bond#:
City: Y�o c.�,n d� Zip:�S3(o� Expiration Date:
Phone: �f S 2--� '�2^ �q S� Alternate Phone:
❑ Insurance-Current:
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Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS TffiS GEOTHERMAL? ❑ Yes ❑No
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTLTs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Buming Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfin
❑ No. Bath Exhaust(must have duct outside) cfin
❑ No. Other Fans: Locations cfin
FiJEL STORAGE (Must be approved by Fire Marshal[if proposing to abandon tank in place.)
❑ Installation ❑ Removal �
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
� Outdoor Grill ❑ Other/List What&Where:
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❑ 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,if this applies; Cost of Pernrit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
� �S °�
X.oi2s$
(contract price) (minimum$50.00)
2. STATE SURCHARGE
x.0005 $
(contract price)
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 doilar 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 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.
T'he 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.
� � J � 71 ,�
Applicant's Signatur : � Date:
3
��� � DATE TIME �
CITY OF ORONO CALLED IN l
INSPECTION NOTICE SCHEDULED - -��--
PERMIT NO.d0/a-OD�l/3 COMPLETED
ADDRESS �53 Z �V'U P��-2.�
OWNER TELEPHONE NO. �Z �� � ���
CONTRACTOR I�U�S�YL-�- e�'
� DESCRIPTION �4S `-'`�"`-� ��- ���� �r� � (
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI � LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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
v � PLUM ❑ FOUNDATION/REMOVAL�"
� OWNERIC NTRACTOR TO MEET YOU:_YES�NO � 4J�GC LLP !�.
��., COMMENTS:
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� �00(ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR W{LL RETURN ❑CITATION ISSUED
O STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANCaE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
Owner/Contractor on site:
inspector. /l�J�1
White Copyllnspector's File Canary CopylSite Notice