HomeMy WebLinkAbout2011-00182 - mechanical CITY OF ORONO PERMIT NO.: 20��-oo�s2
2750 KELLEY PARKWAY
� ORONO, MN 55356- DATE ISSUED: 03/30/2011
' 952 249-4600 FAX: 952 249-4616
ADDRESS : 1925 LAKEVIEW TER +
PIN : 27-118-23-42-0014
LEGAL DESC : LONG LAKE COUNTRY CLUB ADDN
: LOT 002 BLOCK 002
PERMIT TYPE '� : MECHANICAL(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : GAS LINE ONLY
NOTE: GAS LINE FOR DRYER
APPLICANT MECHANICAL(<$500) 15.00
CENTER POINT ENERGY MINNEGASCO STATE SURCHARGE MECH(<$500) 5.00
9320 EVERGREEN BLVD NW
SUITE B MAIL-IN FEE 2.00
COON RAPIDS,MN 55433 MISC FEE 0.00
(763)757-6202 TOTAL 22.00
OWNER
NETISHEN, STEVEN&KELLY
1925 LAKEVIEW TER
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
• shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days a[any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
'•revoked at any time for due cause.
"�/tit.A�.i,C 1n� l l l l
Applicant Permitee Signature Date
Issued By nature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE.
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/�� \ FOR CITY L'SE ONZY
�y� `'� � City of Orono
� , u ;� ¢ � �' P.O.Box 66 Date Received: Permit#
:�� ��;'' 27�0 Kelley Parl.tivay
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� j;y'p �•' Crystal Bay,MN>j3�3 Approved By: Amount$:
* - , o�% Phone(9�2)249-4600 Fax(9�2)249-4516
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CITY OF ORONO-MECHANICAL PERMIT
(All Commercial permits must be approved by the Building O�cial or Inspector and/or Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical permits by mai]or in person at the City offices. Applications will
be reviewed and a permit wiil be issued within two working 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 Desions—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air conditioning installation includin�
heat loss/heat gain calculation,design temperatures,equipment ratin�s and identification as to
type,manufacturer and model. Data shall be presented on form provided.
4. When any new construction or remodelin�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. Al]work must be inspected(rou�h-in and final). Call(953)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
(Check All That A I )
�]Residential ❑ Commercial(Approval Required)
❑ New ❑Additional ❑Repairs ❑Replace
Job Site/Owner Information:
Site Address: 1� 01"�) ^ ��,��V� I�J I...[��
Owner: �����F�1'1���ir�vlailin�Address: � � �/1:� /VQ�;{/��Q,(,�� � �
, �
Cityt�Ybf 1C� _ Zip: �����r�
Home Phone: ��- �%.��0� /� Alternate Phone:
Contractor Information:
_ Contractor: CENTERPOINT ENERGY_ Contact Person: JOANN ZINKEN
Address: 9320 EVERGREEN BLVD NW State Bond#: 22013346
SUITE B
City: COON RAPIDS Zip: 55433 Expiration Date: nR/�OJ2011
Phone: 763-757-6202 Alternate Phone:
� IriSUt2riCe—CUYT'erit: Travelers Indemnity Company
1 Workers Compensation&Employers Liability
Policy#TC2K-UB_9349B101
Policy Period Ol/Ol/2011-Ol/Ol/2012
� i �
MECHANICAL SYSTEMS BEING INSTALLED
,
Note: All Geothermal Systems will now require a Site Plan&Review by our BuildinQ Official.
IS THIS GEOTHERMAL? ❑ Yes ❑No
HEATING SY"STEIVIS
Quantity:
1�Iake:
Model:
Fuel:
Flue Size: ,
Input BTUs:
Output BTUs:
CFIvI:
COOLING SYSTENIS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
Gas Factory Fireplace Brand Name:
Wood Burning Fireplace
Wood Stove Model No.:
Wood Stove With Flue
VENTILATION
No. Kitchen Exhaust duct recirculating cfm
No. Bath Exhaust(must have duct outside) cfm
No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.) �,/�
j� C/' •
� Installation � Removal �/ r� C�(/�/Q
Fuel Oil: gallons ❑ Underground ❑Inside ❑ Outside �
LP Gas: gallons
Other:
GAS LINE ONLY
Outdoor Grill � Other/List What&Where: ��
2
�
.
PERMIT FEE CALCULATION(S)
BASED OFF -2002 STATE STATUE
� Yes,this section applies
The replacement of a Residential fixture or apoliance that meets all three of the followintr requirements:
1. Does not require modification to electrica]or gas service.
2. Has a total cost of$500.00 or less;excludino 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 Surchar�e $ 5.00
i Mail-In Fee(If Applicable) $_ 2.�� F
Total Permit Fee $_ '�'� ,��
PERMIT FEE CALCULATION(S -70BS OVER$500.00
If above does not apply;follow�uidelines below:
1. CONTR4CT PRICE * is 1.2�%of contract price with a(Nlinimum Fee of$50.00)
x .0125$
(contract price) (minimum$50.00)
2. STATE StiRCHARGE ** Add the State Bid�Code Div. Surcharse(�Iinimum Fee of�5.00)
x.000� $
(contract price) (minimum$5.00)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount char�ed for the
permitted work including materials, ]abor,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 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 si�ned copy of the actual contract.
■ **The STATE SURCHARGE is .0005 times the Contract Price or a minimum of$5.00.
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.
� �Applicant's Sijn ture: � � Date:
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