HomeMy WebLinkAbout2015-01009 - mechanical •
� CITY OF ORONO * 2 0 1 5 - 1 0 0 9 *
2750 KELLEY PARKWAY DATE ISSUE : 08/10/2015
, ORONO,MN 55356-
' 952 249-4600 FAX: 952 249-4616
ADDRESS : 2670 KELLEY PKWY 310
PIN : 33-118-23-12-0078
LEGAL DESC : STONEBAY OF ORONO CONDOMINIUM
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE , : MECHANICAL-MULTIPLE
VALUATION � : $ 4,200.00
NOTE: (1)LENNOX FURNA E-66,000 INPUT BTU'S AND 62,000 OUTPUT BTU'S
APP ICANT MECHANICAL 52.50
STATE SURCHARGE MECH(VALUATION) 2.10
MARSH HEATING&AIR COND TOTAL 54.60
6248 LAKELAND AVE N � payment(s)
MINNEAPOLIS,MN 55428 CHECK 85665 54.60
(763)536-0667
Minnesota State License#: ech-MB003532
OWNER
WOLF,MARK&DANELL�
2670 KELLEY PKWY#310�310
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is i sued shall be performed according to
the approved plans and specificati s,applicable City approvals,and the
State Building Code. This permit i for only the work described and dces
not grant permission for additional or related work which requires separate
permits. All provisions of laws an ordinances governing this type of work
shall be compied with whether or t 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.
1'he applicant is responsible for ass ing all required inspections are
requested in conformance with the tate Building Code.This pennit may be
revoked at any time for due cause.
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Applican ermitee Signature ; Date Issue y ignature Dat
FOR CITY CSE ONLY
�`�y���` Cl�Of OCOIlO
f� �`���\
P.O.Box 66 Date Received: Permit#
� '� 2750[�elley Parkway
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Crystal Bay,MN>j323 Approved By: Amount$:
� Phone(9�2)2d9-d600 Fa�(9�2)249-4616
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``.�!.� �.��' CITY OF ORONO—MECHANICAL PERMIT
h�f�S E�i Ca�•
�,_..,..__� (All Commercial permits mi�st be approved by the Buildins Official or Inspector and/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
VALID UNTIL YOU RECEIVE A PERMIT. WORK NIUST NOT BEGIN liNTIL THE
PERI�IIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desians—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air conditionina installation including
heat loss/heat gain calculation,design temperatures,equipment ratings and identi�cation 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. I
5. All work must be done in accordance with the Uniform Mechanical Code/State Buildine Code
requirements. �
6. All work must be inspected(rough-in and final). Call (952)249-4600.
(24-43 hour notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
(Check All That A 1 ) �
[�Residential ❑ Commercial(Approval Required)
❑ New ❑ Additional ❑ Repairs [�Replace
i �
Job Site / Owner Information:
Site Address: Z�'1L' f''e��t� -�/1� � ���
Owner: ����� ���-� Mailing Address: S�-VYl E' �
City: ����(� Zip: C���J��%
Home Phone: Alternate Phone: I
Contractor Infarmation:
Contractor: I���il.i��1 �"��,Tl�''lG')�� ��erntact Person: ����� �1�.��
�J
Address: �(I��}� ��(,���C�.I�1C� �'- � State Bond#: ��(����,���-
City: ����� (✓� F��'�Zip:�j�-�Z�EYpiration Date: �������-'
Phone: ���.��''(�(�1�� Alternate Phone:
❑ Insurance —Current:
1
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MECHANICAL SYSTEMS BEING INSTALLED �
Note: All Geothermal Systems will now require a Site Plan& Review by our Building Offi�ial.
IS THIS GEOTHERNIAL? ❑ Yes �No '
HEATIVG SYSTEMS I
Quantity I
Make: �{��C'x
Model: �/�L��j����L���Y ��"�
Fuel:
Flue Size:
Input BTUs: �����l�L
Output BTUs: �'2 � �� Q
CFM:
COOLING SI'STEi��S �
Quantity:
Make:
ModeL
Tons:
H. Power
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ VJood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ Na Kitchen Exhaust duct recirculating q�fm
❑ No. Bath Exhaust(must have duct outside) �fm
❑ No. Other Fans: Locations Cfm
FLiEL STOR�GE (Must be approved by Fire�Ylarshall if proposirig to nba�zdn�i tank irl pince.)
❑ 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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?:P�RIv�T�EE CALCU�.ATIQN S �.
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. � .
BASED(�FF- 2t�a2 S�TATE �FAT�E '
❑ Yes,this section applies
The replaCement of a Residential fixture or alpliance that meets all three of the following requireme ts:
l 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
3i Is improved, installed or replaced by the homeowner or licensed contractor.
' Skip next section,if this applies; Cost of Permit $ 15.0
State Surcharge $ 1.0
Mail-In Fee(If Applicable) $ 2.0
Total Permit Fee $
P�:�MIT FEE C.A�CLTL:A��}� S �-7Q��t�iT��:'��(��}.Otl
If above d�es not apply;follow guidelines below:
1: CONTRACT PRICE * is 125%o contract price y✓ith a(Minimum Fee of$50.00)
I �� . � X.oizs $
(contract price) (minimum 550.0 )
2. STATE SURCHARGE
x.0005 $
(contract price)
3.I POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4.I' TOTAL PERMIT FEE(Add Lines 1-3 Above) $
• * CO�TRACT PRICE or JOB COST means the actual or estimated dollar amount charged or the
permi ed work including materials, labor,profit, and other fixed costs. It is the amount to be c arged
to the customer for the work done. If any material, equipment, labor or installations are fumis ed by
the o�ner, tenant or any other party, the reasonable market value of such items must be added to the
estima�ed cost or contract price for permit fee purposes. In the event that there is a dispute n the
amount of the job cost, the City may request the submission of a signed copy of the actual c tract.
IvIECHAN��AL PERMIT`.APFL��'�TI��A,G�E�4�1'`T �:
4,'!
The under�igned hereby applies to the City for issuance of a Mechanical Permit, agrees to o all
wark in strict accordance with the ordinances of the City and the regulations of the St te of
Minnesota�, and certi�es that all statements made on this application are complete, tru and
correct. �
Applicant"s Signature: Date: /
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