HomeMy WebLinkAbout2014-01057 - mechanical t �� CITY OF ORONO * Z 0 1 4 - 0 1 0 5 7 *
2750 KELLEY PARKWAY DAT ISSUED: 09/18/2014
ORONO,MN 55356- '
952 249-4600 FAX: (952 249-4616
ADDRESS : 568 KEENE AVE I
PIN : 02-117-23-31-0042 '
LEGAL DESC : MINNETONKA BLUFFS
: LOT 000 BLOCK 016
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYP : RESIDENTIAL
CONSTRUCTIO TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 2,150.00
NOTE: FUJITSU A,�C LJNIT-3/4 TON
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUA ION) 1.08
SKYLINE HEAT G LLC TOTAL 51.08
480 S SKYLINE RIVE Payment(s)
ROBERTS,MN 5 023- CHECK 1483 51.08
Minnesota State LiCense#:mech-MB645084
OWNER
DAVIDSON,DO ALD&JOANNE
568 KEENE AVE.
WAYZATA,MN 5391-
AGREEM NT AND SWORN STATEMENT
The work for which th s permit is issued shall be perfortned according to
the approved plans an specifications,applicable City approvals,and the
State Building Code. his permit is for only the work described and does
not grant permission f r additional or related work which requires separate
permits. All provision of laws and ordinances governing this type of work
shall be compied with hether or not specified herein.This permit will
expire and become nul and void if construction authorized is not
commenced within 18 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 respo sible for assuring all required inspections are
requested in conform ce with the State Building Code.This permit may be
revoked at any time fo due cause.
9��� / /
pp ermitee ignature Date Is ed By Signature Date
,
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� � 'F R C Y USE U LY
I �O A} City of Orono ` ��
�yO P.O.Box 66 Date Recea Permi #
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By: Amo t$:
Phone(952)249-4600 Fax(952)249-4616
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�q �.�' CITY OF ORONO-MECHANICAL PERM T
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(All Commercial permits must be approved by the Building Official or Inspector end! r Fire Marshall)
G NERAL INFORl'�IATIC)l�i
I 1. You may apply for mechanical permits by mail or in person at the City offices. App�ications will
be reviewed and a permit will be issued within two working days.
II 2. Permit cards will be sent by return mail after a review is completed. PERMITS AR�NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNT THE
PERMIT CARD IS POSTED ON THE JOB SITE.
I 3. Mechanical Desiens—Complete calculations,details and specifications are required or each
heating,ventilation,humidification-dehumidification,and air conditioning installati including
heat loss/heat gain calculation, design temperatures,equipment ratings and identific ion as to
type,manufacturer and model. Data shall be presented on form provided.
I4. When any new construction or remodeling is involved,a separate building permit m�st be
obtained.
5. All work must be done in accordance with the Uniform Mechanical Code/State Builc�ing 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.
' - TYPjE OF PERA�SIT"
' (Ck�eck All'That A �
�Residential ❑ Commercial(Approvat Required)
❑I New [�Additional ❑Repairs ❑ Repla¢e
Job Site/Owner�nfc�rmation:
Sit�Address: s� �l /`���-n� t.S�
Ow�er:�ou.,"�-� Q�:c�.sb� Mailing Address: S�� ��t��
Cit � lJ�- z.� Zip: S S 3`��
�
' Hor�ie Phone: Alternate Phone:
Co tractor Infortnation:
Co tractor: c� {« � ���- Contact Person: �� --��
Ad ess: �80 S S ;•�- 'Pf Staxe Bond#: �1� -ScbB
Cit : ��-'� �� Zip:Sy�-3 Expiration Date: /�- $-/
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Pho�e: 7/ S- `I�o" ti 1 c7�Ft Alternate Phone: --' I
❑ Insurance-Current: ��
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Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THYS GEOTHERMAL? ❑ Yes [�No
HEATING SYSTEMS
Quantity: fi'
Make: "
Model: ,L�+a�-°'�
—�
Fuel: «
Flue Size:
Input BTUs:
Output BTUs: "
CFM:
COOLING SYSTEMS
Quantity: �
Make: ..: :'�S�l
Model: �ti D �i
Tons: -3 �
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 E�chaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by Fi�e Marshall 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:
2
.
� r
. .
� Yes,this section applies i
Th�replacement of a Residential fixture or appliance that meets all three of the following reqµirements:
1. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliancek and
3. Is improved, installed or replaced by the homeowner or licensed contractor. I
Skip next section, if this applies; Cost of Permit $ � 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $� 2.00
Total Permit Fee $
�—
I
.
If a ove does not apply; follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$5�.00)
�
�v�/Sc�'— x.0125$ �,
(contract price) (minimum 550.00)
2. STATE SURCHARGE
x.0005 $
(contract price) I
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.b0
�� 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ I
■ � CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
�ermitted work including materials, labor,profit, and other fixed costs. It is the amount t be charged
tp the customer for the work done. If any material, equipment, labor or installations are ished by
e owner, tenant or any other party, the reasonable market value of such items must be dded to the
stimated cost or contract price for permit fee purposes. In the event that there is a di pute on the
ount of the job cost, the City may request the submission of a signed copy of the act�al contract.
I
The �ndersigned hereby applies to the City for issuance of a Mechanical Permit, agre�s to do all
work m strict accordance with the ordinances of the City and the regulations of tl�e State of
Minn sota, and certifies that all statements made on this application are complete� true and
corre t. I
Appli ant's Signature: Date: —/�J
3
� � �� ✓
CITY OF ORONO CALLED IN r����
INSPECTION NOTICE CHEDULED GI� �
PERMIT NO. d COMPLETED
ADDRESS � �
OWNER TEL �/P�� NE NO. s���Z�" /
CONTRACTO � i��TG / / O
� DESCRIPTION ����K�C �/�
� ❑ 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
J ❑ PLUMBING RI ❑ SEPTIC FINAL O FOUNDATION/REMOVAL
� OWNERICONTRACTUR TO MEET YOU:_YES_NO
v�, COMMENTS:
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GW ❑WORKSATISFACTORY:PROCEED OJECT COMPLEfE
� ❑CORRECT WORK 8 PROCEED O IS E CERTIFICATE OF OCCUPANCY
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� ❑COHRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BE�ORECOVERING PEfiMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
� INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STQP ORDER POSTED.CALL INSPECTOR
O IN�PECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hou in advance. ( , ) 249-4600
OwnerlContractor on site:
Inspector.
White Copyllnspector's Ffle ✓ Canary CopyfSite Notice