HomeMy WebLinkAbout2007-P11646 - gas line inspection t PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P11646
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued:
10/31/2007
SITE ADDRESS: 2507 Kelly Ave Unit#
Excelsior,MN 55331
PID: 20-117-23-12-0063
DESCRIPTION:
Proposed Use: Residential ���'� `��-,." �/S ��
Permit Class: General
Permit Type: Mechanical Permits Permit Sub-type(s): Gas Line Inspection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Gas Line to Pool Heater
FEE SUMMARY: Permit Fee: $ 35.00 valuation: $ 1,200.00
State Surcharge Fee: $ 0.60
TOTAL FEE: $ 35.60
APPLICANT: Metro Gas Installers OWNER: Thomas&Kristen Ritchie
685 141st Lane NW 2507 Kelly Ave
Andover,MN 55304 Excelsior,MN 55331
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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LICANT PERMI �G S NATURE I ED BY SIGNATURE
Copies: l-File(SignaturesRequired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, 1-Septic) Page 1
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� 1 � FOR CITY USE ONLY
,��� City of Orono
O h O P.O.I3ox 66 Date Received: Permit#
��<;, 2750 Kelley Parkway
a �l� `� Crystal Bay,MN 55323 Approved By: Amount$:
����f�o�6o`� (952)249-4600
CITY OF ORONO —MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical pernuts 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 wili 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 Desi ns—Complete calculations, details and specifications are required for each
heating, ventilation,humidification-dehumidification, and air conditioning installarion including
heat loss/heat gain calculation, design temperatures, equipment ratings and identification as to
type, manufacturer and model. Data shali be presented on form provided.
4. When any new construction or remodeling is invoived,a separate building permit must be
obtained.
5. All work mu�t 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 fmal.
TYPE OF PERMIT
(Check All That Apply)
�Residential ❑ Commercial(Approval Required)
�New ❑ Additional ❑ Repairs ❑ Replace
Job Site/ Owner Information:
c�i " �� ���
Si�e Address; ��
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Owner: �� Mailing Address: ��i� � ��
c�ty: �/�i(�''� z�p� �J�3/�
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Home Phone:�/c� � Alternate Phone:
Contractor Information:
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Contractor: �/ �' �''� Co tact Person: � ^,�
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Address: � � -t�- ��% Statc Eond #:
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City: Zip✓✓ Expiration Date: �� � �
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Phone: ��j✓`/✓' �� 1l/ � Alternate Phone: ��� ,�J ��/�
❑ Insurance— Current:
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MECHANICAL SYSTEMS BEING INSTALLED
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HEATING SY EMS \ ��
Quantity: � ��
Make� "�✓ �
Mo el: � J�
Fu 1: �
Flue ize:
Input B �� , 'l�L�
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) cfm
❑ 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:
GAS LINE ONLY
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❑ Outdoor Grill Other/List What&Where: ��'�..�'�-�� �� ��
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(—�� PERMIT FEE CALCULATtON(S)
� BAS�D OFF - 2002 STATE STATUE
❑ Yes, this secrion 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 tota] 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 Pernut $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $
PER11�1'1'FEE �AI:CULATION(S)-JOBS OVER;$SO�:QO �' �
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 $ ��� J\/
(contract price) (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of�.50)
x.0005 $ �v
(contract price) (minimum� .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 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
permitted work including matenals, 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 STATE SURCHARGE is .0005 of the Building Department at(952)249-4600 for the price.
MECHA1vICAL PERMIT APPL�CATION AGREEMENT
The undersigned hereby applies to the City far issuance of a Mechanical Permit, agrees to do all
work in strict accardance with the ordin ces of the City and the regulations of the State of
Minnesota, and certifies that all state ts made on this application are complete, true and
correct.
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Applicant's Signature: � � � � Date: � �� " �
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