HomeMy WebLinkAbout2015-01472 - mechanical CITY OF ORONO * 2 0 1 5 - 0 1 4 7 2 *
� 2750 KELLEY PARKWAY DATE ISSUED: l U17/2015
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 : HEATING SYSTEMS
VALUATION : $ 3,395.00
NOTE: REPLACE HEATING SYSTEM(BRYANT)
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.70
SABRE HEATING&AIR COND INC. MpIL-IN FEE 2.00
15535 MEDINA ROAD
PLYMOUTH,MN 55447- TOTAL 53.70
(763)473-2267 Payment(s)
CREDIT CARD 9764 53.70
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 goveming 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 are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause. � �
4��� � � �C� v"���f�st� �� � ( 7� /
Applicant Permitee Signature Date Issued By Signature Date
LL/i7/z015 TVE ia: 31 FAx 763 a73 8565 Snbre Hadting 6 �.r Cond �00z/o0a
,
1�OA CLTY Ul9R OI�TI:Y
p City 0�OrOnO ��J
� � r.o.Boxb� n�c�x�Y�a: �t-I l�- i�►�t� 20 � !�`7�
�' Q 2750 Kelicy Pnrkwar Q,n
� Cryat�i Hay,MN 55323 Apprwed Ay: 1�1J Amaunt$:
�+ �,� Pha�m(952)2A9-�Gc� Fax(952)249-4616
�
CYTY Ok,QRUNO—MECHAMCAL PERMiT �
(All(;ommcrciul pemtlls muat be a�troved by the Birilding 011icie]or lnspecloc ond/or Fire M�v�l�al l)
. ���,n�o�.Tlarr
1, You may app}y for mechanical permits by mail or in person at the City offic�es. Applirations will
be xeviewed and a permit will bo issued witt�in two working days.
2. prrmit cards wi11 be sent by return mail after a re�iear is complete�. PE1tMITS ARE NOT
. . VALID UNTIL YOU RECE�Vk A P$RIv1Y,'�.W ORI�MUST NdT 13EGIN UNTIL TSE __
. .. ._.._..__.__ .._ ._.... . .. .... ....... . .... .. . ... . . ... .--
R ARb I � � �ST �����ON�T�E JOB ��
3. Mechanicnl Desi,p�—Complete calculstions,dotails and speci£ications ate required�or each
heatirng,ventil,ation,humidi�ication-dehumidification,and air r.onditianing installation including
. heat loss/haat gain calculation,dcsign te�nperatwes,equipmea�t ratings and identification as to
type,manufaeturee and modef, ]�ata shap ba prasoatee�on form prpvided.
� 4. When any new construction or remodeling is involved,a sepnrate buiiduig permit must bo
obtsincd.
5. A11 work must be done in awordanco with the Uaiform Mechnnica[Code/Sta#e Building Codo
requirements.
� 6. All work must be i�nsp�(rough-in and final). Call(952)249-4600.
(Z4-48 hour not�ce required)
7. House�Ieating Test Record must be submiued i�cfore final. __.___
I TYPE OF P�RMIT
Check Al!That 1
[�kesidontisl ❑Commercial(Approval Require�
. ❑Naw ❑Additional ❑Repairs �Repiace
7ob Site/Own�r Information:
� $ite Address: 1"�
� ,n,,
; Owner:l r\�1�. � ��+�1c�r�. IvLaili�ug,Address:
City: ,�r(�710 _ Zip:
Home Phone: �I'rJ2:��3-�1'1� A].teruate Phone:
Contractor Information: � .
Contracior; 1 w Contact person:
Address: State Bvnd#: � �-. �
City; Zip:�� Expiration T?ate: Q-��5�ZD C�
i �
, �lnone: �V���'1�S•ZZV']. _ Alteniate Phoue: 1I/��L5�-�}� g8'
� ❑ �surance—Cux•rent: �
� I . .
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11/17/2015 TUE 1Q: 31 FAx 763 a73 8565 Sdbre Hedting & Ai.r Cond �003/OOa
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� Note: AlI Geothermal Systems will now requirc a ite Plan 8t Revie by our Duilding Offiaial.
� IS TSIS GrEOTHERMALT ❑Yes �10 .
I HEATING SYSTEMS
Quantity: ' �
Make:
hiodal: ��t''� VU1Q01��,
. .�u�l: --�---�--. . . . . . .. _ .. � --�----�----
Flue Size;
Input�TUs� _
Output B1`i1s: ����OD
, CFM�
CAOLTNG SYS�MS
IQuantity: ----
MSke:
Mndef�
i
Tons:
H,Power
1�'IREPLACES '
, ❑ Gaa Factory Pireplace Brand Name;
0 Wood Burning niroplaco
[] Wood Stova Modal No.: _
❑ Wood Stave with Flue/Masoary
VI�'NTIi�AT��N �
. ❑ No. Kitchen�xhaust duct recirculating cfm
� No. Batla Exhaust(must have duct outside) efm
No. Othcr Fans: Locations ��
F[TEL STO il AGIC (Jl�ust be a�roved by I+Fre Marshall ij�xogoseng ta nbando��tai:k an pla�c�)
, ❑ Installntion Q Removal
Puel Oil: gapons ❑ Under�round ❑Insida ❑Outside
LP G�s: gallons
0 thar:
GAS LIN�ONLY
Q Outdaor GrilI ❑ O�I�cr/List What&Where:
2
11/17/2015 TUE 1a: 31 FAx 763 a73 8565 Sdbre He�tinq b Air Cond �40a/004
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❑ Yes,this section�pplies
'fhe replacement of a$ssidential fixtura or aonliance that meets all three of the following requirements;
a. not roquire modification to electrical or gas sarvice.
2. Has a tofal cost of SS00.00 or loss;g�y�jpg the cost of the�Mture or appliance;and
3. Is improve�installed or replaced by the homeowner or licensed contractor.
. ._.. _.__ _ _�,,. __.___.. .
.. . . . .. . ..
Skip next section,if this�pplies, � �ost of Pern�it � � $ � �15.00
3tata Surcharga $ 5•00
Mail-In Fee(Tf Applicable) � 2.00
Total Permit Tee S
Jf above does not appl�+;fotlow guidelines b41ow.
1. CONTRACT PIt10E * is 125%of con�act price with a(Miaimum Fee of SS0.00)
33A�.nn �.o�as� �o.n(Z_�
(oontract price)' (mltiiwum S90.00)
2, �TA'I`�SCIYtCHARG�
3 3�5.ou X.000s � I��0
(��n�)
3, POSTAGE&HANDT,TNG(Only on Mail-In Applicat�ons) $ 2.0� _
, 4. TO'�'A�,PPRNIIT FE,�(Add Lin�s 1-3 Above�) S �J�•�� ,,,
� � " CONTRACT PRIC� or JOB COST means the aciva.l or estimated dollsr aneount charged for the
� permii#ed work including matarials,Iabor,profit,and othar fixed costs. It is the annount to be cbarged
I to the c��stomor for the work done. If any material, equipme�rt, labor ar installations are furniahed by
' the owner,tenant or aay other party,ihe�easonable market value of such items r�wat be added to the
estimated cost or contract price for pennit feo purposas. In the a�vent that there is a dispute on the
sxr�ount of tho job cost, tho City may request tha submission of a signed copy of the actual contract,
The�u1dorsigned hereby applies to the City for issuance of a Mechanical�'err�it, a�'oes to do all
work iu slrict accordancc with tho ordir�ar�cos of tkxo C�ty and the regulatious of die State of
Minnesota, and certifies that a11 statements made on tlus application are complete, ttue and
' COfTCCt. .
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Applie�az�,t's Signat�u-e: � Date: �,��� �"�����
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