HomeMy WebLinkAbout2007-P10814 - gas line inspection W � � Y PERMIT
CI�Y �F ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P10814
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued:
3/7/2007
SITE ADDRESS: 3675 Jacobs Mill Rd Unit#
Long Lake,MN 55356
P��� 32-118-23-24-0012
DESCRIPTION:
Proposed Use: Residenrial
Permit Class: General
Pernut Type: Mechanical Pernuts Pernvt Sub-type(s): Gas Line Inspecrion
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 35.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Blue Water Plumbing OWNER: Jeffrey&Kari R Ament
5026 Alpha Road 3675 Jacobs Mill Rd
Princeton,MN 55371 Long Lake,MN 55356
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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APPLI ANT PERMITEE SIGNATURE ISS D Y SIGNATURE � J
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
t ` �OR CITY USE ONLY
rp� City of Orono
P.O.Box 66 Date Received: Pennit#
�4,.. � 2750 Kelley Parkway
a ''���'� Crystal Bay,MN 55323 Approved By: Amount$:
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��';�����y.�.�o (952)249-4600
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CITY OF ORONO—MECHANICAL PERMIT
(All Commercial pennits must be approved by the Building Official or Inspector and/or Pire Marshall)
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 RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PCRMIT 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 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 separate building permit must be
obtained.
5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code
requirements.
b. 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 A:11 That A ply)
�Residen#ial ❑Commercial(Approval Required)
❑ New ❑Additional ❑Repairs ❑Replace
Job Site/Owner Information: •
SiteAddress: �� �,S JGcc�jS/�'�l�� /��
Owner: Mailing Address:
City: C��Gt�C� Zip:
Home Phone: Alternate Phone:
Contractor Information:
' .�., � ��
D , ti��� �
Contractor: ,D`�� r,v�� �fw��'� Contact Person: i
Address: �a-6 ����/� State Bond#: �I'3 �y 743��
City: �v�G Zip:�� Expiration Date:
Phone:�r_'`L���6'��y`/ Alternate Phone`��3/oZ.3����
�l d b
❑ Insurance—Current:
1
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n •�
: MEGHANICAL'SYSTEMS`BEING INSTALLED r
HEATING SYSTEMS
Quantity: �
Make:
Model:
Fuel:
Flue Size:
Input BTUs
Output BTUs:
� CFM:
COOLING SYSTEMS
� Quantity: � �
Make:
Model:
Tons:
H.Power
FIREPLACES
❑ Gas Factory Fireplace
❑ ' Wood Burning Fireplace
❑ Wood Stove
❑ Wood Stove With Flue
Brand Name: Model No.:
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfin
❑ No. Other Fans: Locations cfm
FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑Outside
LP Gas: gallons
Other:
CAS LINE ONLY
�,
❑ Outdoor Grill ❑ Other/List What&Where: -+� ��� d�G.c�'
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. . ,
. . , .
: PERMIT FEE CALCULATIbN(S)'
BASED OFF - 2002 STATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the foliowing requirements:
l. 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 Pennit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $
' - PERMIT:FEE CALCULATION(S),-JOBS OVER$500.00`
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$35.00)
x.0125$
(contract price) (minimum$35.00)
2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of�.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(n�tly on N1ai1-In A�plications) $ 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
pennitted 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 tlle 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 Building Department at(952)249-4600 for the price.
: MECHANICAL.PERMIT APPLICATION AGREEMENT.
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
work iii strict accordance with the ordinances af the City ar,d tr,e regulations af the State af
Minnesota, and certifies that all statements made on this application are complete, true and
correct.
Applicant's Signahire: ���r��,���� Date: �j"—7 �
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