HomeMy WebLinkAbout2017-00510 (replace boiler system) CITY OF ORONO * 2 0 1 7 - a 0 5 1 0 *
' 2750 KELLEY PARKWAY DATE ISSUED: OS/17/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952 249-4616
ADDRESS : 3295 CARMAN RD
PIN : 20-117-23-14-0014
LEGAL DESC : CARMAN COVE
: LOT 008 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 8,435.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
REPLACE:BOILER SYSTEM(NYTHERMAL)
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APPLICANT MECHANICAL 105.44
STATE SURCHARGE MECH(VALUATION) 4.22
SELECT MECHANICAL SERVICES INC.
6219 CAMBRIDGE ST TOTAL 109.66
ST.LOUIS PARK,MN 55416- Payment(s)
(952)926-4488 , CREDIT CARD 4447 109.66
Minnesota State License#:mech-MB003390
OWNER
DIEBEL,JAMES&DEVON
3295 CARMAN RD
EXCELSIOR,MN 55331-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perfortned according to
the approved plans and specifications,applicable Ciry 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 Iaws 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 wi the State Building Code.This permit may be
revoked at time fo ue c se. J`.,
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� S /� /� � �c� �.�z`f� �� / 7 �
Applicant Permi ee ignature ate Issued By Signature Date
• ' FOR CITY USE ONLY
' City of Orono �I.—�I� permit# I� p Li�� �
�O� P.O.Box 66 Date Received:� ,�,� /�
0 2750 Kelley Pazkway �('� (G'Yi'
Crystal Bay,MN 55323 Approved By: Amount$: �(,��I •
Phone(952)249�600 Fa�c(952)249-4616
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!qK£5 H���G CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector and/or Fire Mazshall)
GENERAL INFORMATION
1. You may apply for mechanical pernuts 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—Compiete calculations,details and specifications are required for each
heating,ventilarion,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 construcrion 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
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Job Site/Owner Information:
Site Address: �Z 9s ��R/�'f JO/� RD/Q�
Owner: �la,�'�,�5�� ��UO/� ����J�� Mailing Address: 3Z�S ��O�M.A�/eD�Q�
c��y: fxr.��.S��12 z�p: SS33/
Home Phone: Alternate Phone: 10�� 3�� �`���
Contractor Information:
S�G�G�
Contractor: /��' f/�4JJICAI. .5,�'�Ul�Contact Person: C'��i/� �'�V�1'��
Address: loZ/�G�AI�I tgRI�G�'�T. State Bond#: /y�00'3�3`�!�
City: ,��vl.s /��k Zip:��� Expiration Date: 9 / �
Phone: /�2.�Z�o•��88 Alternate Phone:
❑ Insurance—Current:
1
MECHANICAL SYSTEMS BEING INSTALLED
Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes�No
i
HEATING SYSTEMS
Quantity: I "
Make: Z�101- \ !��
Model: � � �d L�
Fuel: ]��. G�
Flue Size: 3 G'
InputBTUs: � �Ov
Output BTLTs: �
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 cfm
❑ No. Bath Exhaust(must have duct outside) cfin
❑ No. Other Fans: Locarions c�
FUEL STORAGE (Must be approved by Fire Marshall ijproposing 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:
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PERMIT FEE CALCULATIONS
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
� �, � x.0125$ ���• ��
( ontract price) (minimum$50.00)
2. STATE SURCHARGE w ZZ
� y 3 5�, X.000s $ �-�
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $
i �} lo�
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 1 D ) �
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
pernutted 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
estixnated cost or contract price for pernut 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 Pernut, agrees to do all
wark in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota,and certifies that all s ments made on this application are complete,true and correct.
Applicant's Signature: Date: � �? �
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