HomeMy WebLinkAbout2016-00793 - mechanical CITY OF ORONO * Z 0 1 6 - 0 P1 7 9 3 *
' ' 2750 KELLEY PARKWAY DATE ISSUED: 07/1U2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1810 LAKEVIEW TER
PIN : 27-118-23-43-0005
LEGAL DESC : LONG LAKE COUNTRY CLUB ADDN
: LOT 001 BLOCK 004
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHAN[CAL-MULTIPLE
VALUATION : $ 8,500.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
(2)RUUD HEATING SYSTEMS
(1)RUDD COOLING SYSTEM
APPLICANT MECHANICAL 106.25
STATE SURCHARGE MECH(VALUATION) 4.25
PROFESSIONAL MECHANICAL SERVICES MAIL-IN FEE 2.00
8851 E.RESEARCH CTR RD
NEW HOPE,MN 55428- TOTAL 112.50
(763)657-7421 Payment(s)
Minnesota State License#: mech-MB003767 CREDIT CARD 9795 112.50
OWNER
DOLLAR,CHARLES
1810 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 governing 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 afrer 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.
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Applicant Permitee Signature Date Issued B Signature Date
F 'I"Y TJSE ONLY
Cify of Orono f{ 'j
i ��� P.O.Box 66 Date Receivc : U � Permi[# ��� �"—�' .� ��'�`
� 2750 Kelley Parkway
� Crysta�Liay,YII`55323 Appmvcd By: Amou�i S: �/O�. �
Phone(952)249-4600 Fax(952)249-46l6
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�.qK�s�o��c�' CITY OF ORON4-MECHANICAL PERMTT
(All Com:nercia!perntits must bc appro�cd by the Building Offcial or]nspector and�or Fire Mars6a11)
�__ ___ ._.__---
i GENERAL II�FFORMATION � �
1. You may apply for me�hanical permits by mail or in person at the Ciry offices. Applica.tions will
be reviewed and a permit wi�l be issued within two working days.
�. Perrnit cards will be sent by return mail after a review is completed. PERMITS ARE NOT
V_AL,ID UNTIL YOU RECEIVE A PERMIT. WORK MUST�TOT BEGIN UNTIL THE
PERMIT CARD I$POSTED�l�'THE JOB SITE.
3. Mec3�anical Desi�ns—Compiete ca[culations,details and specifications are requu�d for each
heating,ventilatioq humidification-dehumidification,and a�r conditioning instailation including
heat loss/heat gain calcula6on,design temperatures,equipment ratings and identification as to
type,manufacturer and modeL Data shall be gresented on form provided.
4. ��Vhen any new constructifln or remodeting is involved,a separate building pernut must be
obtained.
5. Ali work rnust be done in accordance with the Uniform Mecha+lical CodeJState$uilding Cnde
requirements.
6. All work mus�be insgected(rough-in and final). Call(952)249-46Q0.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before final.
��_____�
T'YPE OF PERrv1IT
l (Check All That Apply)
�Residential ❑Comrnercia[(Approvai Required) [Backflow Device: ❑AVB ❑PVB]
❑ Ne�v ❑Additional ❑ Repairs �Replace
Job Site l Qwner L3formatiQn:� �_^
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Site Address: ��y� �-��t�1�1�2--� �'�/f'�(�Gf �
Owner:��,��t`�`��1 �`e^�f Mailing Address_ i.��V � �t�� 7�-
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c�Ty: C�r�`Yl C� z�p: J�5 3 5� _
Home Phone: ���i " ��- ���3 Alternate Phone:
Contractor Information:
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Contractor: ���C��l�YIuX ���.,�it,(.�ll�o�ct Person: (� �D�J�-�
Address: ���� �. fi tr°�(.�'�`'7_L_%� '-State Bond#: ��QQ�� f��
City: �� Zip: ���' Expiration Date: �-o������ �'
Phone: ��Q�J " �J��" ��,�--�_ Alternate Phone:
❑ Insurance-Current: �`(,S ��'�r�
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� MECHAi�IGAL SYSTEIVIS BEING I�ISTALLED
Note:All Geothermal Systems wil!now require a Site Plan&Review by our Building Officia7.
IS TAIS GEaTHERMAL? ❑Yes [�.No
HEATING SYSTEMS
Quant�ty: d�
Make: u.�
Model: ���I T I-� O�v �(
Fuel:
Flue Size:
Input B'i'Us:
Outp►tt BTUs:
CFM:
COOLING SYSTEMS
Quantity: 1
Make:
Model: }�J3� �,�A
Tons: � ��
H.Power
FIREPLACES
❑ Gas Factory Fireplace Brand Namc:
❑ Wooc�Surning Firepiace
❑ �t�ood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTII.ATION
❑ No. Kitchen Exhaust duct reci�culating cfm
❑ No. Bath Exhaust(must have duct outside) �
❑ No. Other Fans: Locations ��
FUEL STORAGE (Must be approved by Fire Marshall if proposing to abando�lank in plac�)
❑ Installarion ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
j] Outdoor Grill ❑ Other/List 1Nhat&Where:
2
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_. .._ PERMIT FEE Ct�LCUI.ATTONS
i. CUNTRACT PRICE *is 1.25%of contract price with a{Minimum Fee of$50.00)
� �� .(�� x.O125$ ��� d+7�
(eontract pricc) (minimu�a!LSO.OQ)
2. STATE SURCHARGE �"
�'J`�TU . L�'�% �:_ooas � �• aJ
(contract pricc)
3. POSTAGE&HANDZ.i3VG(Only an Mail-In Appiications) $ 2.00
4. TOTAL PERMTT FEE(Add Lines 1-3 Above) $ [�v� �
• * CONTRACT PRICE or JOB COST means the actual or estimated dollaz amount charged for the
permitted work including materials,labor,profit,and other fixed costs. It is the arnount to be charged
to the customer for the work done. If any material,equipment,labor or installations are furnished by ihe
owner, tenant or any other party, the reasanable market value of such items must be added to the
estimated cost ar contract price for peimit 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.
MEC�IA�iICAT;PERMiT APPLICATION AGREEMENT
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agxees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota.and certifies that statement ade on this applieation are complete,true and correct.
Appiicant's Signa . l�� Date: r 'd � ��
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