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Home My WebLink About2012-00862 - mechanical ' CITY OF ORONO * z 0 1 z - 0 0 8 6 z * , 2750 KELLEY PARKWAY DATE ISSUED: 08/30/2012 ORONO, MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 375 LEAF ST PIN : OS-117-23-14-0059 LEGAL DESC : BAYSIDE WOODS : LOT 002 BLOCK 001 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : COOLING SYSTEMS VALUATION : $ 2,600.00 APPLICANT MECHANICAL 50.00 RESIDENTIAL HEATING&AIR,INC. STATE SURCHARGE MECH(VALUATION) 1.30 1815 EAST 41ST STREET SUITE A MINNEAPOLIS,MN 55407- MAIL-IN FEE 2.00 (612)724-1899 TOTAL 53.30 OWNER GILBERTSON ET AL,MICHAEL R 375 LEAF ST 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 dces not grant permission for additional or related work which requires sepazate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This pertnit 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 By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. c FOR CITY USE ONLY � �"�` City of Orono ��4 ��'� P.O.l3ox 66 Date Received: Pennit# �;,;�, 2750 Kcllcy Parkway �� ; o�/`� Ph n(52)24y 46003 I-'ax(952)249�616 Approved By: Amount$: ��,. CITY OF ORONO— MECHANICAL PERMIT ,;;" `. (All Commercial pertnits musl be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL INFORMATION � I 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 RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desi�ns—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 Record must be submitted before final. T'YPE OF PERMIT (Check All That A 1 ) ' Residential ❑Commercial(Approval Required) ��`� �� ❑ New ❑Additional ❑Repairs ❑Replace ^ Job Site/Owner Information: � Site Address: 3 7�'J �ecti� � � < «--� Owner: M�� v ;� ��r� S v-� Mailing Address: '�7 ,5 L�ti�- ;5��-� City: �J�� zip: .5 S i s � Home Phone: �,t Z •$1 U - �515C Alternate Phone: �' . Contractor Information: i Contractor: �s:��-4-,�\ �--��.,�� Contact Person: �� Address: I��5 C_ ��` Sz - S��h State Bond#: L"� 5 �S y�1�i S ; City: �.��r�-�� •S Zip:,��(��-Expiration Date: ci "�2- � �2- Phone: (;c Z-"1 L�'t4S�jCi Alternate Phone: ❑ Insurance—Current: ��-5 1 � � MECHANICAL SYSTEMS BEING INSTALLED Note:All Geothermal Systems will now require a Site Plan& Review by our Building Official. IS THIS GEOTHERMAL? ❑Yes [�]'l�lo HEATING SYSTEMS Quantity: i ,, ! � ; Make: '; , ' — �, Model: Fuel: Flue Size: Input BTUs: Output BTUs: CFM: COOLING SYSTEMS Quantity: � Make: C�C C�L,r i Model: `��-1/t�C3 3 3 C� � Tons: 3- o H.Power FIREPLACES ❑ Gas Factory Fireplace Brand Name: ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry V ENTILATION ❑ 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.) �r,� � ❑ Installation ❑ Removal 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 appliance that meets all three of the following requirements: I � 1. Does not require modification to electrical or gas service. �� 2. �-Ias a total cost of$500.00 or less;excludin�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-In Fee(If Applicable) $ 2.00 � Total Permit Fee $ 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 Fee of$50.00) V"� �5 J ��0� X .0125$ �j Q (contract price) (minimum$50.00) �,i, 2. STATE SURCHARGE ��' 3U I Z��U x .0005 $ � I � (contract price) 'i,3��. �. 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 r. �� 4. TOTAL PERMIT FEE(Add Lines l-3 Above) $ �}� ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials,labor,pro�t, 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 with t e ardinances f the y and the regulations of the State of Minnesota, and certifies that all tatements m de o t is application are complete, true and correct. � Applicant's Signature: � � `�� z-- Reset Form 3 � �E :��