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Home My WebLink About2015-01431 - heating system , CITY OF ORONO * 2 0 1 5 - 0 1 4 3 1 * � 2750 KELLEY PARKWAY DATE ISSUED: 1U06/2015 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3675 JACOBS MILL RD PIN : 32-118-23-24-0012 LEGAL DESC : JACOBS MILL : LOT 002 BLOCK 002 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : HEATING SYSTEMS VALUATION : $ 3,758.00 NOTE: REPLACE HEATING SYSTEM(BRYANT) APPLICANT MECHANICAL 50.00 STATE SURCHARGE MECH (VALUATION) 1.88 MN HEATING&AIR COND. MAIL-IN FEE 2.00 10701 93RD AVE NE MAPLE GROVE, MN 55369- TOTAL 53.88 (763)424-5235 Payment(s) Minnesota State License#: BUIL-MB003270 CREDIT CARD 3130 53.88 OWNER AMENT,JEFFREY& KARI 3675 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. /��? ` 1`'J�r�l� ��_� ��1.., ','._ . ,�L,C ��'� IJ,�t._L- f��-- l( � �; (�� (J, Applicant Permitee Signature � Date Issued By Signatur� Date g-��O C ITY OF ORONO � � Street Address: Mailing Address: Telephone(952)249-4600 ��, � 2750 Keliey Parkway P.O. Box 66 Fax (952)249-4616 !q F,�' Orono,MN 55356 Crystal Bay, MN 55323 www.ci.orono.mn.us KFsr►o� � FOR CITY USE ONLY City of Orono c � �O NO P.O.Box 66 Date Received: ��ermit# ��f J� � �� 2750 Kelley Parkway Crystal Bay,MN 55323 Approved By: � Amount$: 53 -� I � Phone(952)249-4600 Fax(952)249-4616 ��. �A� . `� CITY OF ORONO-MECHANICAL PERMIT . !��l� (Ail Commcrcial permits must be approved by the Building Official or Inspector ancl/or Fire 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 VAL1D 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-dehumidificarion, 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. 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 A 1 ) esidential ❑ Commercial(Approval Required) ❑ New ❑Additional ❑Repairs eplace Job Site / Owner Information: Site Address: ?� � c ' �`td�E,[�, ►M: 1' i�2111 Owner:_��' �4r��o�,�f Mailing Address: S�µM� City: (�/-�9 o Zip: -S s�s�� Home Phone: �i'��L-a,��q—y'�� Alternate Phone: �U�A Contractor Information: Contractor: � �� Contact Person: , Address: ic,�e�i -9.�seve'..U. .�p, State Bond#: l�tA�3 0� �t7 City: WI,e elP LYRDc.c Zip: s s-�Expiration Date: �/�/A1o/6 Phone: �E� S<dfl;1 oC3! — Alternate Phone: �� „��6 -!�3'��S " �nsurance-Current: 1 ' MECHANICAL SYSTEMS BEING 1NSTALLED � Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. IS THIS GEOTHERMAL? ❑ Yes To HEATING SYSTEMS Quantity: � Make: �e��,� Model: ��/G,T�AO60/�'D Fuel: �U�O� ��S' Flue Size: 3^'/�i/G Input BTUs: /e% ry,�f� Output BTUs: //7 /'1'�js/ CFM: �Cz�� 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 ❑ Na Kitchen Exhaust duct recirculating efm ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans Locations cfin FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in plaee.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List What&Where: 2 / PERMIT FEE CALCULATION(S) BASED OFF - 2002 STATE STATUE ❑ 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; excludinQ 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 Permit $ 15.00 State Surcharge $ 1.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ PERMIT FEE CALCULATION(S)—JOBS OVER $500.00 If above does not apply, follow guidelines below: 1. CONTRACT PRICE * is 125%of contract price with a(Minimum Fee of$SOA� �� J �37�^� � X .oi2s $ ; (contract price) minimum$50.00) 2. STATE SURCHARGE �3 �s�. �- X .0005 � r.�� (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 rj �� 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ i 6 � , ■ * 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 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. MECHANICAL PERMIT APPLICATION AGREEMENT The undersigned hereby applies to the City far issuance of a Mechanical Permit, agrees to do all work in strict accardance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements made n this application are complete, true and correct. � � Applicant's Signatur . Date: �/��/��a � 3