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Home My WebLink About2013-00322 - gas line only ' � CITY OF ORONO * 2 0 1 3 - 0 0 3 2 2 * 2750 KELLEY PARKWAY DATE ISSUED: OS/07/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2515 KELLY AVE PIN : 20-117-23-12-0038 LEGAL DESC : REG. LAND SURVEY NO. 1428 : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY VALUATION : $ 1,005.00 NOTE: GASLINE FOR OUTDOOR GRILL APPLICANT MECHANICAL 50.00 AC TOMPKINS PLBG& HEATING STATE SURCHARGE MECH(VALUATION) 0.50 16445 221ST AVE NW ELK RIVER, MN 55330- TOTAL 50.50 (952)420-9028 OWNER HARDTEN, DAVID&CHRISTINE 2515 KELLY AVE EXCELSIOR, MN 55331- AGREEMENT AND SWORN STATEMENT The work for which[his 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 separate 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 nuli and void if construc[ion 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 are requested in conformance with the State Building Code.This permit may be revoked at y t cause. � � , �� , i3 � � Applicant Permitee Signature Date Issu By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. F TY USE ONLY \ City of Orono ��3,_ a_ /�O^/O P.O.Box 66 Date Receiv . Permit# � 2750 Kelley Parkway Crystal Bay,MN 55323 Approved By: Amount$: �' ( � Phone(952)249-4600 F�(952)249-4616 � � � � \Y� � ' \qk f�H��``' 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 permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two warking days. 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTII,YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical DesiQns—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 construcrion 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 fmal). Call(952)249-4600. (24-48 hour notice re�uired) 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 Job Site/Owner Information: Site Address: �y/S �cl��-y �� ._—_—_—�. ' Owner: ,/,%•��'�ei•-� Mailing Address: �/.%� �cl� �'`� /�'��;f' City: ��`� �� Zip: Home Phone: ��3 - /�� }Sv Alternate Phone: �� 9�U--3.��b Contractor Information: Contractor: �� /��s j�j/�dntac Person: ��✓�� ss Address: �5�� "a�� 't''� State Bond#: /�6 ��%�7/l City: ��' Zip:sS33 D Expiration Date: �%a'�� Phane: 9�a' ��'9oa� Alternate Phane: �6��0'�3- �� ❑ Insurance—Current: 1 ��H�I�Ti��L S►�l'�'�'�I��B�T�a Il�TS'�'�I.LEI? ' Note: All Geothermal Systems will now require a Si e P an& vi w by our Building Official. IS THIS GEOTHERMAL? ❑Yes ❑No HEATING SYSTEMS QuantitY: Make: Model: Fuel: Flue Size: Input BTiJs: Output BTUs: CFM: COOLING SYSTEMS Quantiry: Make: Model: Tons: H.Power F'IRE L�ACF.� ❑ Gas Factory Fireplace Brand Name: ❑ Wood Buming Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENT�LATIQN ❑ No. Kitchen Exhaust duct recirculating cfin ❑ No. Bath Exhaust(must have duct outside) cfrn ❑ No. Other Fans: Locations cfin FUEL STORAGE (Must be qpproved by F'rre Marshall�Jpropasing to afiantlon tank fn plac�) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside LP Gas: gallons Other: GAS LINE ONL� � Outdoor Grill ❑ Other/List What&Where: 2 �'�.1T�E CAL�UL�"1��) . BA��D t)►FF-20U2 S'�"A'�E:3TA'i't1� ❑ Yes,this section applies The replacement of a Resid�tial fiadure or aonliance that meets all three of die following requirements: 1. n t require modification to electrical or gas service. 2. Has a tot of�500.00 or less;�xclu�the cost of the fixture or appliance:�nd 3. Is improved,installed or replaced by the homeowner or lice,nsed contractor. 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 S ��r�e�t.cur.�� -a�vs�c��+� If above does not apply;follow guidelines below: 1. CO�j,'�'RACT PRICE *is 1.25%of contract price with a(Minimam Fee of SS0,00) � �/.t1Uy x.012S� y p � (Tcent�t price) (miaimum SS0.99) 2. STATE SURCHARGE � /.�U� � x.0005 $ •S� (contirracc price) 3. POSTAGE&HANDLING(qnly on Mail-In Applications) S 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ S v i ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollaz amount charged for the permitted work including materials,IaUor,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 pariy,the reasonable matket value of such items must b�e 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 tha submission of a signed copy of the actual contract. 1�ECHAI�3ICAL PERtVIIT APp�l�,`�'��`'i�M��`; The undersigned hereby applies to the City for issuance of a Mechanical Permit,a�rees to do all work in strict ac�ordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statemen ade on this application are complete, true and correct. ApplicanYs Signature• Date: .� � �f� � 3 �� DATE TIME � CITY OF ORONO CALLED IN J�'7`�-3 INSPECTION NOTICE SCHEDULED .3=�jl3 � PERMIT NO.aD!3�COMPLE ED ADDRESS � OWNER TEL HONE NO. 5 �� ' �l'O� CONTRACTOR �� nS �� : DESCRIPTION � � l� ❑ FOOTING ❑ PLUMBING FINAL EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI LAKESHORE/WETLANDS � O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPIAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PL.UMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOH TO MEEf YOU:_YES_NO � COMMENTS: � W � � J O a � O � W � � Q � � i� C�u � �� W --' � .�t,�� 7 � b d W ❑WORKSATfSFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WlLL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CAII INSPECTOR O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: Inspector. Whi1e Copyllnspector's File Canary CopylSite Notice ��OI•� D T TIME � CITY OF ORONO CALLED IN 7`- � INSPECTION NOTICE D 3 ��scHE�u�E� - � �� PERMIT NO.o?O�� 0 COMPLETED ADDRESS �S I�J I�--�"-'`� � OWNER TELEPHONE NO. CONTRACTOR _Y�-��r�5�� : DESCRIPTION ��- I �``'`� -" S � � ❑ 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 0 WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP T ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O >. � O � W � Q � Z W � W � � � �� GW ❑WORKSATISFACTORY:PROCEED GC_7 PROJECTCOMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT �CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP OFDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Cail for the next inspection 24 hours in advance. �95Z� 249-46�� OwnerlContractor on site: r � Inspector. f j � White Copyllnspector's File Canary CopylSite Notice