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Home My WebLink About2016-00085 - gas line only r* � 1 CITY OF ORONO * 2 0 1 6 - 0 a 0 8 5 * 2750 KELLEY PARKWAY DATE ISSUED: OU26/2016 ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 3640 JACOBS MILL RD PIN : 32-118-23-24-0010 LEGAL DESC : JACOBS MILL : LOT 004 BLOCK 001 PERMIT TYPE : MECHANICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY VALUATION : $ 350.00 NOTE: GASLINE FOR FIREPLACE IN BASEMENT APPLICANT MECHANICAL 50.00 STATE SURCHARGE MECH(VALUATION) 0.18 SCHULTIES PLUMBING MAIL-IN FEE 2.00 1521 94TH LANE NE TOTAL 52.18 BLAINE,MN 55449 (651)786-4007 Payment(s) Minnesota State License#:plbg-PC644177,mech-MB005379 CHECK 33528 52.18 OWNER HOFFMAN,KEITH&MARY 3640 JACOBS MILL RD LONG LAKE,MN 55356- 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 sepazate 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 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. -� I � Z�� /6 Applicant Permitee Signature Date Issue y Signature Date � ., � ., p�j O pr : a ��r D Q c�tyororono � l ,�� ECEIVED � �O P.O.Box 66 � ` �� 2750 Kelley Parkway ` Crystal Bay,MN 55323 �ppXo�dBp* �,A3ri�t�tC$ �� ; � � �+ q O�� Phone(952)249-4600 Fax(952)249-4616 � �- �� ,.. .. .. 1.��s�o��,� CITY OF ORONO—MECHANICAL PERMIT CITY OF ORONO (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Mazshall) �'��`�{��'��T �. �., 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 UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desiens—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 sepazate 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. '" �`� , "�`'��{�� , � , : ` � " ;�, � ,,.,.. �:� ��Y�.�� v�� Residential ❑Commercial(Approval Required) ❑New [�Additional ❑Repairs ❑Replace �t�� ,�`�il�� .. r..: ,. . . . . � . Site Address: �v Owner: Mailing Address: �� J��2:f�✓�� City: Zip: Home Phone: %-�o�---7/�v"��S� Alternate Phone: � `'��'��i�� r Contractor: Contact Person: Address: / � State Bond#: /� �7 City: ° Zip�� Expiration Date: ��0��6 Phone: 76�7�� ` ��7 Alternate Phone: T��/'�� Insurance—Current: 1 �. a� ' 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) `�� x.0125$� (contract price) (minimum 550.00) 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 dollaz 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 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. Date: o�� 3 � .� � 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 BTiJs: 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/Masonry VENTILATION ❑ No. Kitchen E�chaust duct recirculating cfrn ❑ No. Bath Exhaust(must have duct outside) cfrn ❑ No. Other Fans: Locations cfin FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in plac�) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill � Other/List What&Where: • ,J+1�� 2 . i �- �-- d� � D _� TIME CITY OF ORONO CALLED IN INSPECTION N TICE `��,�sCHEDULED �a(o— ./G� /O�.3 f7 PERMIT NO. � ��CO LETED ADDRESS S �� OWNER •TELEP NO. - `�� CONTRACTOR � DESCRIPTION � � �° � l� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: � W a � � O ). � O � W � Q � 2 W � W � � � d W WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑ RRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WFLL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advan ) 249-46�� OwnerlContractor on site: Inspector. ' White Copyllnspector's File Canary CopylSf e Notice