HomeMy WebLinkAbout2016-00276 - mechanical ,� , CITY OF ORONO * 2 0 1 6 - 0 0 2 7 6 *
� 2750 KELLEY PARKWAY DATE ISSUED: 03/23/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 425 LAKEVIEW PKWY
PIN : 06-117-23-32-0004
LEGAL DESC : LAKEVIEW OF ORONO
: LOT 1 BLOCK 1
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 24,350.00
NOTE: (1)LENNOX FURNACE
(1)LENNOX A/C
(1)KITCHEN EXHAUST
(6)BATH EXHAUST
GASLINE FOR MAIN,FURNACE,RANGE,DRYER AND 3 FIREPLACES
APPLICANT MECHANICAL 30437
STATE SURCHARGE MECH(VALUATION) 12.17
SEDGWICK HEATING&A/C MAIL-IN FEE 2.00
1408 NORTHLAND DR-SUITE 310
MENDOTA HEIGHTS,MN 55118- TOTAL 318.54
(952)881-9000 Payment(s)
CHECK 16524 318.54
OWNER
Source Land Development Inc.
18215 45TH AVE N
STE D
PLYMOUTH,MN 55446-
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 dces
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 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.
� � � /�/ ��
Applicant Permitee Signature Date Issued ignature Date
�I b � � i a �7 �3 � � S�
FOR CITY USE ONLY
�O A}O City of Orono
<y P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By: Amount$:
Phone(952)249-4600 Fax(952)249-4616
R�G �`
��'�'f5Hd4�G CITY OF ORONO—MECHANICAL PERMIT
MA p A � � (All Commercial permits must be approved by the Building Official or lnspector and/or Fire Mazshall)
MI� [
GENERAL INFORMATION
���`�"Y O�ORONO
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 NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN 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 pr�vided.
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) [Backflow Device: ❑AVB ❑PVB]
�New ❑Additional ❑Repairs ❑Replace
Job Site/Owner Information:
Site Address: �oZS �Gl, Q,V1.l,W �(�L�( LaIGtAn �V� , IM��
Owner: �'��M �,S MailingAddress: �� �1S �}-S
1�" E�Y-� 'c�1•
City: � Zip: ��J`�`� �
Home Phone: Alternate Phone:
Contractor Information:
Contractor: -�1��� Contact Person: �t
Address: ���� �'�/ `�� �� State Bond#:
City: ���'Zip: S IZ� Expiration Date:
Phone: ��"�(��'al�� Alternate Phone:
❑ Insurance—Current:
1
'< :. .= : .. ,: . = ��"��[�T�A . �"�`ST`E1�S BE�N`Gr,TI�T� � �.��` ,, ,�`�� . .�-.
/ Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑ Yes ❑No
HEATING SYSTEMS
Quantity: �
Make: `1,
Model: �tX�
Fuel:
Flue Size:
Input BTUs: � �
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity: �
Make: �,E/6 LwV�
Model: C I � � �
Tons:
H.Power
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ VVood Stove with Flue/Mzsor.ry
VENTILATION
No. � Kitchen Exhaust duct recirculating �cfin
No. lP Bath Exhaust(must have duct outside)�TJ l/-(i�. ��cfin
No. Other Fans: Locations � cfm
FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ ���f � �
Outdoor Grill Other/List What&Where: ti , ��-�1'�-�
2 �,�� - 3 �P
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1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
�2�� 3 5v. l�ti� X.o�2s $ 3��-{.��—
(contract price) (minimum 550.00)
2. STATE SURCHARGE
��, 35a. (lu X.000s $ 1 �- i�7
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �� D ��—I
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted 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 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.
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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: 3 r�����'
3
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ATE TIME �
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❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. 9 49-46�0
OwnerlContractor on site: ' �
inspector: `
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OwnerlContractor on site:
Inspector.
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Ca11 for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContractor on site:
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Call for the next inspection 2a hours in advance. (952 j 249-4600
OwnerlCor�tractor on site:
Inspe�tor: �
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DATE TIME
CITY OF ORONO cnLLED IN
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� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
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❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerfContractor on site:
Inspector:
White CopyAnspector's File Canary CopylSite Noties