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Home My WebLink About2011-00049 - gas line only r 1 CITY OF ORONO PERMIT NO.: 2011-00049 t 2750 KELLEY PARKWAY ORONO,MN 55356- DATE IssUEn: OU24/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 1801 LAKEVIEW TER PIN : 27-118-23-43-0004 LEGAL DESC : LONG LAKE COUNTRY CLUB ADDN : LOT 005 BLOCK 003 PERMIT TYPE : MECHANICAL(>$500) � PROPERTY TYPE : RESIDENTIAL ' CONSTRUCTION TYPE : GAS LINE ONLY �: VALUATION : $ 0.00 NOTE: GAS LINE FOR GENERATOR � APPLICANT MECHANICAL 50.00 DEZIEL HVAC INC. STATE SURCHARGE MECH(VALUATION) 5.00 1612 3RD AVE.NE BUFFALO, MN 55313- MAIL-IN FEE 2.00 (612)719-1049 MISC FEE 0.00 TOTAL 57.00 OWNER FROMELL-THEIS,DENNIS THEIS&ANN 1801 LAKEVIEW TER LONG LAKE,MN 55356 AGREEMENT AND SWORN STATEMENT The work for which this 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 goveming this type of work - shall be compied with whether or not speci£ed 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 aze requested in conformance with the State Building Code.This permit may be revoked at any time foF due cadse. `�� —r� / / / / Applicant Permitee Signature Date Issued By Si ure Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO � FOR CITY USE ONLY O¢��O City of Orono P.O.Box 66 Date Received: Permit# 2750 Kelley Parkway ,� n"'x• �,: Crystal Bay,MN 55323 Approved By: Amount$: `t ° ' c`:- Phone(952)249-4600 Fax(952)249-4616 '��<<,<; CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshali) 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 NO"I" VALID UNT(L,YOU RECEIVE A PERMIT. WORK MUST NOT BEG1N UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Designs—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 Rewrd 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: dadadf `� Site Address: � �[�� ,�� ,�� L;� Owner: � � I t.��' Mailing Address: <.��-�' City: Zip: Home Phone: Alternate Phone: Contractor Information: � ., r�i Q-� ��' �� Contractor: �Z �� .Q��n Contact Person: ��Ub�1� � r� ] 2 A\� ^ C� Address: �la[ I U` :J�� 'V�State Bond#: I\1 L O O L) (� I�'� Z-� City: � �l I� Zip:��Expiration Date: � Zr'l�� 1 Phone: ��lJ �0`I"�� J Alternate Phone: � Insurance—Current: �QS 1 ' MECHANICAL SYSTEMS BEING INSTALLED Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. IS THIS GEOTHERMAL? ❑ Yes '�]No /� 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 Brand Name: ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTILATION � � ❑ No. Kitchen Exhaust duct recirculating cfm ❑ No. Bath E�chaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (Must be approved by Fire Marshal!ijproposing to abandon tank in p[ace.) ❑ Installation ❑ Removal \�-' � Fuel Oil: gallons ❑ Underground ❑ Inside ❑Outside LP Gas: gallons Other: � GAS LINE ONLY \ ❑ Outdoor Grill � Other/List What&Where:��,�(,Y�(��:, `� 2 , PERMIT FBE CALCULATION(S) BASED OFF-2002 STATE STATUE Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the fol(owing requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less;excludine 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-!n Fee(If Applicable) $ 2.00 �� C��k `�f�� Total Permit Fee $ 22.00 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 of$50.00) 23.00 25$ 22.00 (contract price) (mioimum 550.00) 2. STATE SURCHARGE **Add the State Bl ode Div.Surcharge(Minimum Fee of 55.00) 22.00 x.0005 $5.00 j (contract price) (minimum$5.00) 3. POSTAGE&HANDLING nly on Mail-In Applications) $ 2.00 �l/' 222.00 4. TOTAL PERMIT�EE(Add Lines 1-3 Above) $ ■ * CONTRACT PRICE or JOB COS"T means the actual or estimated dollar amount charged for the permitted work including materials,labor,profit,and other tixed 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 STATG SURCHARGE is.0005 times the Contract Price or a minimum of$5.00. 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. n � Applicant's Signature. " �1 C _ Date: /� o��I � Reset Form 3 On./� Da�E TIME v CITY OF ORONO CALLED IN �3—L� INSPECTION OTI E SCHEDULED .'S•3 �—� i % PERMIT NO. D� — OD COMPLETED I 1 6/ ADDRESS IS� I �,��LTe/'✓'. OWNER TE E HONE NO.��Z 7/g �D . � CONTRACTOR � DESCRIPTION � � r�S� � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WEfLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVA� Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO c� COMMENTS: a 1� � J O a � O � W � Q � Z W � W � �� W�.WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE OC`�CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFOREC�/ERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the nex inspection 24 hours in advance. (g52) 249-4600 OwnedContract Inspector. White Copyllnspecto�'s File Canary CopylSite Notice