HomeMy WebLinkAbout2005-P08734 - gas line inspection PERMIT
CITY C�F ORONO
275� Kelley Parkway- PO Box 66 Permit Number: p08734
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued: 5/16/2005
SITE ADDRESS: 1800 Lakeview Ter
Long Lake,MN 55356
PID: 27_118-23-43-0007
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Sub-type(s): Gas Line Inspection
Permit Type: Mechanical Permits
DETAILS:
Approvcd perresolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 15.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 15.50
APPLICANT: Hanson Plumbing Co. OWNER: Richard&Viriean Helgeson
10464 Colorado Circle 1800 Lakeview Ter
Bloomington,MN 55438 Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFfED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WTTH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT P RMITEE SIGhATURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnituresRequired), 1-Applicant, 1-MonthlvReports, 1-Assessin�, 1-Finance Page 1
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FOR CITY USE ONLY
,�` City of Orono
' • 4O`�' P.O.Box 66 Date Received: Permit#
��t,, .,,. � 2750 Kelley Parkway
� .� ;�i;'�7� �* Crystal Bay,MN 55323 Approved By: Amount$:
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CITY OF ORONO—MECHANICAL PERMIT
(All Commercial perniits must be approved by the Building Ofticial or Inspector and/or Pire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical pei-�nits by mail or in person at the City offices. Applications will
be reviewed and a permit will be issued within two working days.
2. Peinut cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desi�ns—Complete calculations, details and specifications are required for each
heating, ventilation,hunudification-del�unudification, and air conditioning installation including
heat loss/heat gain calculation, design temperatures, equipment ratings and identification as to
type,manufachuer and model. Data shall be presented on form provided.
4. When any new consnuction or remodeling is involved, a separate building pernut must be
obtained.
5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code
requirements.
6. All work must be inspected(rough-in and final). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be subnutted before finaL
TYPE OF PERMIT
(Check All That A ly)
�Residential ❑ Commercial(Approval Required)
�I�Tew ❑Additional ❑Repairs ❑Replace
Job Site/ Owner Information:
Site Address: �ScJ� � 3,�,,�vr�,a �,✓ � � Y� � e
Owner: ���c� �d�9_' cJ S'O v� Mailing Address:
City: � / ��e Zip:
Home Phone: Alternate Phone:
Contractor Inforn�ation:
Contractor: �hso�� �'/��,.,G,'�, q �, Contact Person: �Oo���7`��S��'
Address: /05�6y �'a�ur���o �;%���c State Bond#: ,D�7b$'S�0
City: �do�i�'a9Zon Zip:SSy3S� Expiration Date: /Z -3i-oS
Phone: ��z /�r1�- �yi 9 Alternate Phone:
❑ Insurance—Current:
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MECHANICAL SYSTEMS BE1NG INSTALLED
HEATING SYSTEMS �
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
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) cfin
❑ 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: �2� /`�a-no�e
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� PERMIT FEE CALCULATION(S)
� BASED OFF - 2002 STATE STATUE
Yes, this section applies
The replacement of a Residential fixture or appliance that meets all tlu�ee of the following requirements:
1. Does not require modification to electrical or gas service.
2. Has a total cost of�500.00 or less;escludin�the cost of the fixture or appliance: and
3. Is improved,installed or replaced by the homeowner or licensed conhactor.
Skip next section, if this applies; Cost of Pernut $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Pernut Fee $
PERMIT FEE CALCULATION(S) —JOBS OVER �500.00
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 $
(contract price) (minimum$35.00)
2. STATE SURCAARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x.0005 $
(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 aniount charged for the
pernutted work including materials, 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 ar contract price for permit fee puiposes. 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(9S2) 249-4600 for the price.
MECHAI�TICAL 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.
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Applicant's Signature � a��''"\ Date:,� 6 0 f
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