HomeMy WebLinkAbout2016-00754 - mechanical � = CITY OF ORONO
2750 KELLEY PARKWAY * � 0 1 6 - 0 0 7 5 4 *
DATE ISSUED: 06/28/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952 249-4616
ADDRESS : 2650 KELLY AVE
PIN : 20-117-23-14-0005
LEGAL DESC : APPLE HILL
: LOT 007 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 7,232.30
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
(1)AMANA FURNACE AND A/C
APPLICANT MECHANICAL 90.40
STATE SURCHARGE MECH(VALUATION) 3.61
NORTHERN HEATING&AIR COND INC. MAIL-IN FEE 2.00
9431 ALPINE DR TOTAL 96.01
RAMSEY,MN 55303
(763)323-7597 Payment(s)
CHECK 24251 96.01
OWNER
WENDLING,STEVEN&DOREE
2650 KELLY AVE
EXCELSIOR,MN 55331-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specif►cations,applicable City approvals,and the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming 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 are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
� ' � -� � ,� ,/�
Applicant Permitee S►gnature Date Issued Signature Date
� FOR ITY USE ONLY
,¢�� City of Orono �Q �/� '��
O h Q P.O.Box 66 �����,r,�*., Date Rede�'�� Permit# ` �
�;,,„r, 2750 Kelley Park�� 4;�, /
a� ��''il��' r Crystal Bay,MN �� Approved By: Amount$:_���
r��i, x,��,yo� Phone(952},249-4600 Fa�{�9,5'�j,�49-4616
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CITY 0�9,�N0-MECHANICAL PERMIT
(All Commercial permits must be ap��ed 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 UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desiens—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 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 )
�Residential ❑Commercial(Approval Required)
❑ New ❑ Additional ❑ Repairs ❑Replace
Job Site/Owner Information:
� �� - �� ,�
Site flddress: �
Owner: �F,l� �►'7 Mailing Address:
SC�r'i�.
c��y: Qr���> z�p: �.���3 y
Home Phone: ��'Z -����P`�- ��'�� Alternate Phone:
Contractor Information:
�j�r-�e.�r�S U'"�- �
Contractor: �ea-ftnG ,� }�►r Contact Person: �b(�v i 0..�
Address: �'(��J� ,�la��.� i�r_ State Bond#: ���'I��
City: � �� Zip:�3 EXpiration Date: Ul O�J�0�p
J
Phone: ��v3- 3Z3- �SGI� Alternate Phone: ��2j-`'� 7' ���
�. Insurance-Current: U � l U�/�(� - �oZ/�0/��p
1
MECHANICAL SYSTEMS BE1NG 1NSTALLED
Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑ Yes �10
HEATING SYSTEMS
Quantity: �
Make:
�
Model: �1'�G('., l(Q(>L����
Fuel:
Flue Size:
Input BTUs:
Output BTL1s:
CFM:
COOLING SYSTEMS
Quantity: �
Make: �'»Q,��`-'
Model: ��)��'
Tons: �
H.Power
FIREPLACES
❑ Gas Factory Firepiace Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen E�chaust duct recirculating cfm
❑ No. Bath Exliaust(must have duct outside) cfin
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by Fire Marshall ijproposing 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
, "y.
PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture or a�pliance 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;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 Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
i PERMIT FEE CALCUL ATION(S)—JOBS OVER$5(10.00
If above does not apply;follo�v guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
,�',32, ?—� X.oi2s $ �� `��
(contract price) (minimum$50.00)
2. STATE SURCHARGE
�2nj2, . �v� x.0005 $ �- �
1 (contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � I�Q•�I
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
pertnitted work inciuding materials, labor,profit, aud othzr fxeci c�sts. It is ihe alnount to be chargad
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 perniit 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 for issuance of a Mechanical Permit, agrees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made on this application are complete, true and
correct.
Applicant's Signature: ���� � � Date:���L����
Reset Form
3
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pA� TIME
CITY OF ORONO CALLED IN - l =-��—+�
INSPECTION N TICE LED ��•ot�
PERMR NO. � P ED
ADDRESS s�
O'WNER E NO.,���la''G��
CONRRACTOR
� DESCRIPTION N �
ly ❑ FOOTIN(i ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q 0 POURED WALL ❑ PLUMBING RI ❑ EXCAVKiRADIN(iIFILLINfi
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAI RI ❑ SITE INSPECTION
i ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
{� „��NSULATION ❑WOOD BURNERIFIREPLACE ❑COMPLAINT
r�o�FINAL ❑WATER HOOK-UP ❑ FOLLOW-UP
�!i L
� ❑AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATIONIREMOVAL
v � DEMO-SITE ❑ SEPTIC INSTALL
� TO MEET 1f0U:_11�_NO
� COMMENTBt
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W ❑YMOFiK SATISFACTORII:PROCEED �COMIPLETE
� O()ORRECT W�Oii1C 8 PROCEED O ISSUE CERTIRC/1TE OF OOGIPYINCY
� ❑COFiRECT WORK,CALL FOR F�tNSPECTION TdAPORARY
V BEFORE COVERINO PEfiAAANBrT
❑CORRECT UNSAFE OOND1710N WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETl1RN
O STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED
O INSPECTION REOUIRED.CALL TO ARRANtiE ACCE8S.
caM br u�e next inspecuo�u nows in�►anos. (952) 249-4600
on site:
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sactory Fib Can�ry Copyl811�Noda
PERMIT# /- �
HOUSE HEATING TEST RECORD
ADDRESS � CITY ��{�(/r;i./�/��
OCCUPANT � � �-7 OWNER �7(�G��
HEAT LOSS�.�C:?r��U� HTG. INST. INSTALLED BY �TC't� � D�✓G
ELECTRICAL WORK BY � i
TYPE OF HEAT GA _ FA HW STEAM SPACE HTR. UNIT HTR OTHER
GAS DESIGN
MAKE ��UL , SERIAL •�,3.3�L/ A-� �'
Mo�EL Tt�..D i GY���'1�° INPUT�sTu> 11�,,c�cs�
CONTROLS ��
KIND OF LINER SIZE � NONE COMPANY TESTING
FILTERS SIZE��o J��S�X I NUMBER NAME OF TESTER ' � � � �/�
PRESSURE 3�S � PERCENT CO2�
INPUT CFH ��✓�a � PERCENT 02 � �
INPUT /dJ��i�dQ� 0��✓�
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