HomeMy WebLinkAbout1992-004677 - mechanical CITY oF ORONO PERMIT
M � 13 3 5 BROWN RD S , BOX 6 6 ��� � �c�:H��r,���.��
CRYSTAL BAY, MN 55323 ERMIT TYPE: {;{���,f�
473-7357 �ermit Number: .���`t���,�._
�)ate Issued:
SITE ADDRESS:
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FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SI NATU
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CITY OF ORONO
APPLICATION FOR MECHANICAL PERMIT
GENERAI, .INFORM2�TION
l. You may apply for mechanical permits by mail or in person at the City
offices. Mailed-in permits are subject to the postage and handling fees
shown be I ow.
2. Permit cards will be sent by return mail the same day the application is
received. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT
BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE.
3. When any new construction or remodeling is involved, a separate building
permit must be obtained.
4. All work must be done in accordance with State Building Code requirements.
5. AlI work must be inspected (rough-in and final). CaII 473-7357. 24-hour
notice required.
6. House Heating Test Record must be submitted before final.
�NSTRIICTI�i3S CompY?te aI 1 items on this app�ication. Compute the permit fee.
Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.
If you have questions, call 473-7357.
WALK-IN PERMITS apply at City Offices, 1335 South Brown Road (Cty. Rd 146)
MAIL-IN PERMITS enclose fee - Mail to: P.O. Box 66, Crystal Bay, MN 55323
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Please check one: New Addition Repair �Replace
JOB SITE: / � ��_ Zip: s�
�wner's Name: �.Q Telephone Num er:
Kailing Address: � �- City: Zip:
�ontractor' s Ivame: VOG � � ``"'°''''" Telephone Number:
Kailing Address City: Zip:
********************* '�E�A��-41�t�********************************************
KINIMUM FEE ( $30. 00 per project)
k*it�t***1F**�Y*�F*�F*****ic*�k*�Fic***�F*�k*************�Y***�t*�k**�kiF************�t***********
SYSTEM .DESCRIPTION: $15.00 each unit
3eating SystemS:
2uantity:
�Sake.
'�ode2. � - _
?uel:
?lue Size:
Cnput BTUs. �p r�
)utput BTUs:
�FM:
k**�Fy1r�k�F�F�F**�t*�k*�tr*�Ir*****�t�F�F�t�t*iF�t�k****�F**ityt�k***yk***1Ir***�F�cir***ir�F****�Ir***iF�F****�k�k*�F11r
:ooling Systems:
2uantity:
4ake:
Rodel: -
Cons: -
i.Powe r:
F�tt**********************************�k*�k�k*ylr**�k***********************�k*�Irie********
�CT 5 ri9�
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*WOOD BURNING EQIIIPMENT $15. 00 each unit
Wood stove with flue
Wood combination or add-on unit
Factory fireplace with flue
Factor Fireplace (s ) freestanding Masonry
Wood Stove (s ) franklin, other
BrandName Model No.
Mfgr's Min. , Clearances, side , rear , min. flue dia.
Total
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VENTILATION $15.00 each project
No. Kitchen Exhaust ducted recirculating cfm
No. � Bath Exhaust (must be ducied ou�csi�e) c��m
No. Other Fans: Locations cfm
Total
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FIIEL STORAGE (must be approved by fire marshal)
;�";: � $30. 00 Permanent/Temporary
k;:` �'uel oil, gallons underground inside outside
LP Gas, gallons
Other Gas opening
****�***************************************************************************
GAS LINE INSPECTION
High/Low Pressure $15. 00
�t*�kirzycic*�tic�czxir�c�ixx�'t�iicic**xic�*�cir�ticiti:�c�e*�cirati*�xSc�*:t�'.c��t:'k��iic**yc�x::��:':��cjc+*:k**�*ak+*t�s
PERMIT FEE CALCQLATION
1. Total of above Installations or Minimum Fee ($30.00) $
2 . State Surcharge. Add the State Building Code Division
Surcharge to each permit $ . 50
3. Postage and Handling on all mailed-in applications, S 1. 50
4. TOTAL PERMIT FEE add lines 1-3 above ��,�'�
The undersigned hereby applies to the City of issuance of a Mechanical Permit,
agrees to do all work in strict accordance with the ordinances of the City and
the regulations of the Minnesota State Builr.iing Code, and cer�ifie� th�:t all
statements made on this application are complete, true and correct.
Applicant' s Signature: C�(,1 � Date: �o�
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���� �HOUSE HEATING TEST RECORD � ! �/� �
ADDRESS L� �� �� �� ��� U �' APT. FLOOR CITY SUBURB v ���'t�
OCCUPANT OWNER
HEAT LOSS DATE HTG. INST. r �
SOLD BY INSTALLED BY �aU '� � � f
Electrical Work By Gas Lins By ��L��2
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE • �'� MAKE OF BURNER
Model '�' Modsl
Sxia l �6 - Max. BTU Ratiny
INPUT �� N� MAKE OF FURNACE
Model
✓ CONTROLS 11
THERMOSTAT Heat Pluy Vent Size
Valvs KIND OF LINER� SIZE NONE
Limit ,N' f' Draft Hood �� Reyula�or
Limit Setting �1 �C1 Filters Siza Nu ber
Fan Setting Q Chimney Location Inside�0utsida
Pilot Type � *J Chimnsy Construction � � rr�_�
P;lot Make �
Pilot Model �—�— $moke Bomb Wiring -1�
Pilot Timing � �� �-�- Draft ��— Test Tay
L.W, Cut Off Door Pressure Liyhtin9 ��•+ 1
Prossuro L � � P�rcent COZ �� 1' Date Tested ` �
Input CFH �� �`"` Percent 0 Company Testing �
Stack Temp. � Perc�nt C0� l�—�� Name of Tester
Form 235