HomeMy WebLinkAbout2017-00564 - mechanical CITY OF ORONO * 2 0 1 7 - PJ P1 5 6 4 *
2750 KELLEY PARKWAY DATE ISSUED: OS/25/2017
ORONO, MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 3525 LYRIC AVE
PIN : 17-117-23-43-0102
LEGAL DESC : NAVARRE HEIGHTS
: LOT 000 BLOCK 007
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 2,527.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
(1)YORK HEATING SYSTEM-NATURAL GAS-80,000 INPUT BTU'S
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.26
STANDARD HEATING&AIR CONDITIOMNG MAIL-IN FEE 2.00
130 PLYMOUTH AVENUE N.
MINNEAPOLIS,MN 55411- TOTAL 53.26
612-824-2656 Payment(s)
CHECK 53907 53.26
OWNER
Citifinancial Services Inc.
3525 LYRIC AVE
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEME1vT
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 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 construc[ion 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.
L � � Jri2.5i /7
Applicant Permitee Signature Date Issued By ignature Date
f FOR CITl'LiSE ONI,1"
=�'-� Cit��of Orono
l�g'���, P.O.Bos 66 Date Rzcei��ed: Perntif 7
� aa;,� � 2750 Kelley Parkway
t{� '�'�;v �'f� Crystal Bay,MN 55323 :�pproti-ed By: Amount S:
���?���e�/� (952)249-4600
\�� .
CITY OF ORONO—MECHANICAL PERMIT � � _�.�
(All Commercial pe�mits must be approved by the Building Official or Inspector andlor Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanieal permits by mail or in person at the City offices. Applications will
be reviewed and a pennit will be issued within two working days.
2. Permit cards will be sent by retum mail after a review is completed. PERMITS t\RE NOT ���+��V��
VALID UNfIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTII,THE
PERMTT CARD IS POSTED ON THE JOB SITE. MAY 2 5 2O 17
3. Mechanical Desi¢ns—Complete calculations,details and specifications are required for each
heating,ventilation,humidification dehumidification,and air conditioning installation includ'u}gTM OF
heat loss/heat gain calculation,design temperatures,equipment ratings and iden�cation as to�'� ORONO
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.
(2448 hour notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
Check All That A lv
�Residential �Commercial(Approval Required)
❑New ❑Additionai ❑Repairs �Replace
Job Site 1 O�vner Information:
Site Address: �� �� � r(,
Owner:� ' "��" �e. f.'� MailingAddress: 5��,
City: �r�Q Zip: �s�
Home Phon��•� �� � ��1� Alternate Phone:
Contractor Information:
Contrac�r�ndar ' ing Contact Person:
130 Plymouth Avenue North
Address: Minnea olis,MN 55411-3445 State Bond#:
81 .
City: Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance—Current:
1
. � '� '�';MECHANIG�A�.:S'�STEI�S BEING INSTALLED ;`
Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes�No
HEATING SYSTEMS
Quantity: �
Make: /� �
Model: �
Fuel: /
Flue Size:
Input BTUs: �
Output BTUs:
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
VENTILATION
❑ No. Kitchen Exl�aust duct recirculating cfin
❑ No. Bath Eachaust(must ha�e duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Mr�.st be appro>>ed by Fire Marshall ifproposing to abandon tank in place.)
� Installation � Removal
Fuel Oil: gallons ❑ Underground a Inside �Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill � Other/List What&Where:
2
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
��y� x.0125$ �� • " �
(contract price) (minimum 550.00)
��
2. STATE SURCHARGE ....1
�' � x.000s $ � � y�
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ , �'�
■ * 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.
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
work in strict accordance with the ordina es City and the regulations of the State of
Minnesota,and certifies tha statements a on thi application are complete,true and correct.
A licant's Si nature: e: S�i3 �
PP g
3