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Home My WebLink About2016-01486 - mechanical � —�� CITY OF ORONO * Z 0 1 6 - 0 1 4 8 6 * 2750 KELLEY PARKWAY DATE ISSUED: 1 U28/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 80 LEAF ST PIN : 04-117-23-22-0004 LEGAL DESC : REG. LAND SURVEY NO. 0744 : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : HEATING SYSTEMS VALUATION : $ 3,100.00 NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. (1)RUUD NATURAL GAS FURANCE APPLICANT MECHANICAL 50.00 STATE SURCHARGE MECH(VALUATION) 1.55 CENTERPOINT ENERGY MAIL-IN FEE 2.00 6161 GOLDEN VALLEY RD BUILDING A TOTAL 53.55 GOLDEN VALLEY,MN 55422- Payment(s) (763)512-2765 CHECK 20678 53.55 Minnesota State License#: mech-MB003503 OWNER HALL,JEROME 80 LEAF ST LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according ro 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 l80 days at any time after 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. � , i �. %� ��c�t� `-�/ Sti i.��i� Applicant Permitee Signature Date [ssued By Sig ure Date � r `.�- RECEIV FO�CI 1'USE ONLY City of Orono � /, �O�O P.O.Box 66 NOv 2 �� te Received! � �1� Permit# �"�� 2750 Kelley Parkway �j Crystal Bay,MN 55323 Approved By: Amount$: ,/� Phone(952)249-4600 Faz� � � y� ; .. �' CITY OF ORONO—MECHANICAL PERMIT ��k£5 H�� q��Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL INFORMATION L 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 RECENE 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-dehumidifieation,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 wark 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 I-�eating 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: 80 LEAF STREET owner: JERRY HALL Mailing Address: HO LEAF ST c;ty: LONG LAKE Z;p: 55356 Home Phone: 6�2-3J6-3� � 5 Alternate Phone: Contractor Information: Contractor: CENTERPOINT ENERGY Contact Person: JOANN ZINKEN ACIC1CeSS: 6161 GOLDEN VALLEY RD,BLDG A St2te BOriCI #: MB003503 Clty: GOLDEN VALLEY Z1}�: MN Expiration Date: osi2oi2o�s P�1011e: 763-512-2765 Alternate Phone: OLD REPUBLIC INSURANCE CO. ❑ f WORKERS COMP&EMPLOYERS LIABILITY InsuranCe—l�''Urrent. POLICY#WLRCC48597075 oni irv ocoinn_nvnvon�as��n�np�� 1 • a . Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. IS THIS GEOTHERMAL? ❑ Yes �]No HEATING SYSTEMS Quantity: 1 Make: RUUD Model: R801 PA075-317MSA Fuel: NAT. GAS Flue Size: Input BTUs: 75,000 ouc�ut BTus: 60,000 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 cfin ❑ No. Bath Eachaust(must have duct outside) cfin ❑ No. Other Fans: Locations cfrn FUEL STORAGE (Must be approved by Fire Marsha[1 if proposing to abandon tank in place.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List What&Where: 2 Y a � .�' PERMIT FEE CALCULATIONS 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) 3100.00 X.o t 2s $ 50.00 (contract price) (minimum 550.00) 2. STATESURCHARGE 3��pp X.000s $ 1 55 (contract price) 3. POSTAGE&NANDLING (Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 53.55 ■ * 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. 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 ith the ordinances of the City and the regulations of the State of Minnesota,and certifies t a all statements made on this application are complete,true and correct. Applicant's Signature: � �jDate: 2� 3 r� ^.�L� , DATE TIME '� CITY OF ORONO CALLED IN INSPECTION OT CE J/' SCHEDULED ��' �✓�^ PERMIT NO.- , �"'� COM LEfED , ADDRESS ,�� i �� ,S/ OWNER TELEPHONE NO. 7��5�� 5 CONTRACTOR ��,,��1��=/�'J�f � DESCRIPTION � /�GC.d ��'�/�Iu � -� Ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING ��j ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v SITE � $�PTIC INSTALL �QNTRACTOR TO MEET Y�U:f�YES_No � L � COMMENT'� _ 1�'�1 I�I�� C/ �� 7� S�(� � j — 1��r-„r � — �-� ��(— � ° , � � �N ��-c� ��, .�i � � Q !� 1�.' .S �.c -E:; � �' � �-;� L� ��- z � W � %l J O W ❑WORK SATISFACTORY:PROCEED ECT COMPLETE � ❑CORRECT WORK 6 PROCEED ❑ISSUE CERTIFICATE OF OCWPANCY W � ❑CORRECT NfORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CWERIN(3 PERMANENT ❑OORRECT UNSAFE CONDITION WRHIN HOURS. p pHpTO TAKEN INSPECTOR WILL RETURN ❑GTATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site• inspector: �� vrh�ce covyn�.Peo�or.Fi�e c.�.►y co�r�sn.Na�cs House he�tin� t��t ��c�cnr� RECt —_ nterPoint. ergy ��C � `3 ;�0�" CITY OF ORONO Owner ��Y P' �--�� Controls � Conversion Address�b (�E� S Apt rhermostat �� Heatplug l/entSize �'7� ��b��-�7 City � ��``� t/alve j,(i-Z, Kind of liner/size Heat loss Date htg. inst �� ✓1��Y' Limit Drafthood ��✓t Regulator � �'�`�- �/ Soldbv CenterPoint Energy Limitsetting / �Q Filters:Size /�''�� Number�¢�� Installed bv CenterPoint Energy Fan setting Chimney locations: Q Inside Q Outside Pilot t e Chimne construction L�-2:��'� Electrical workbv CenterPoint Energy yp v Heat type �FA �Space heater Pilot make �y"�j,'�,.� Wiring "� Test tag �'`" / �� Gas line by 1�� Pilot mode/ Lighting Inst � Date tested��',:�� Unit heater Other Pilot timing companv resr�nq CenterPoint Energy Pressure:Hi fire/Lo fire � Tester's name � l�'� '� Gas design �' �- �'�� n Percent CO2 �z.��i Make �� Model „�j!Ci�(f'1�''"� � Serial na �ti(;��(�5�•�� Input CFH �I} Percent Oz +,�� -� -r,� � Input ��%�j Stack temp �`C'�' Percent CO�' CNP 235(11-2008)