HomeMy WebLinkAbout2002-P04930 - mechanical CI�Y �F ORONO PERMIT
2750�Kelley Parkway - PO Box 66 Permit Number: Po493o
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued: 2�2g�2oo2
SITE ADDRESS: 1170 Loma Linda Ave
Mound,MN 55364
P��: 08-117-23-23-0015
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Mechanical Permits Permit Sub-type(s): Multiple Mechanical Items
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 58.06 Valuation: $ 4,645.00
State Surcharge Fee: $ 2.32
Misc. Fee: $ 1.50
TOTAL FEE: $ 61.88
APPLICANT: Ace Mechanical Services OWNER: G&G Holding Co. Ltd Partnership
4820 Lexington Ave 1140 Loma Linda Ave
Ham Lake,MN 55304 Mound MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PIiRMITEE SIGNATURE ; SUED BY SIGNATURE
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Copies: 1-File(Si�nitures Required), 1-Aoplicant, 1-Monthlv Reports, 1-Assessing, 1-Finance Page 1
Feb-25-2002 03:43pm From-CITY OF ORONO +9522494616 T-752 P.004/006 F-492
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CYTY OF ORONO Al'l'T,ICATION FOR MECI�AI�TYCAL PERMIT �3J
Box 66 (2750 Kelley Parkway) ���
Crystal Bay, M1�T 55323 � �
�
G�NLRAL INFORMATTON'
1. You may apply for mechanical permits by mail or in person at�the City offices. Applications r�vill be
reviewed and a permit will be issued within two working days.
2. Parmit cards will be sent by return mail after a r�:view is completed.PERMITS ARE N'07 VAT.ID
UNTIL YOU REC�TVE A p�RMIT.WORK 1�fU'S1'NOT Bi;G1N UNT[L.'Y"HE PE1tMI'f CARD IS
. Pas�D oN r�ro�sYr�.
3. Mechanical Designs-Complete calculations,details and specii'ications are required for each heating,
ventilation,humidification-dehumidifi�ation, and air condition ing inscallation including heat loss/heat
gain calculation,design temperatures, equipment ratings and ic�lentification as to rype,manufaciurer and
m�ael.I7ata shail'oe prese���ed or.form provideci.I3enti ica�i��r of and speci�ca:ions for w�.ter�eating
equipmeni shall also be provided.
4. When any new construction or remodeling is involved, a separ;tte building pertnit must be obtained.
5. All work must be done in accordance with tha li�niform Mecha nical Code/State Building Code
requirements.
6. All work must be inspected(rough-in and final). Call(952)24'��600.24-hour notice required.
7. House Heating Test Record must be submitted before final.
Tnstructions
Complete all items on this application. Compute the permit Fee. Sign and date the certification.
INCOMPLETE APPLICATIONS WILL N4T BE PROCE�;SED. Tf you have quesuons, call
(952) 249-4600.
Please check one: ❑New ❑ Addition ❑ Repair �Re��lace,�Residential ❑ Commercial
�, /
/I 7� l-"�'�i'^�.�)L/i_.". ✓--�� �7Lfl.l�-..
J'OB SITE: //G/1 / ��,-�--� . .-�.�� Zip: ��.3[, �1'
Owner's Name: ��>/�,l.�,;,_r _ Phone hlumber:
�hilc�g P_ddress: ._. �itY� _. Z�p� _ ____
Contractor's Name:��. %%�1�,5.,��c,��Sc�,:.�hone Ivumber: 7t-:� � `%�' `� "v�� ��
Maili�ng Address: y.�'��(� L c�h.,���f.�_��t3'�.�' C -s Zip:�"s�v�1
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fab-25-2002 03:44Pm Prom-CITY OF ORONO +9522494616 T-752 P.005/006 F-492
SYST'EM DESCRIPTTON
HEATINC SYSTEMS
Quantity: I ..
Make: �� �m ,
Model: �C/�1.4+y4,�G�Uc�i'C?
FueL• . �-�' -
Flue Size: c;���r111C
Tnput BTUs: �,�-' L�c� _,.
o„�ut BTus: � 7 3 G�Q _
��r,,�: l_2 t�C)
COOLING SYST�MS
Quantiry: ��C�S ������ ,_
Make,
Model: _
Tons: , ,.
H.Power _
FIREPLACES
❑ Gas factory fireplace
❑ Wood burning factory fireplace with flue
❑ 'V�/ood Sto�ve
❑ Wood stove with flue
Brand Name _ Model No.
VENTILATION
No. TCiLchen Exhaust duct recalculating_„_cfrn
No.�Bath Exhausc(must have duct outside) �,y�'cfm
No: Other Fans:Locations �cfm
FUEL STORAGE(MUST BE APPROVED BY 1�1R�MARS�I�0.I.)
[) Installation or ❑Remo�val
(� Fuel oil: gallons ❑underground ❑ inside ❑outside
❑LP Gas: gallons
❑ Other Gas opening
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Feb-25-2002 03:44pm From-CITY OF ORONO +9522494616 T-T52 P.006/006 F-492
PERMIT FEE CALCULATION(S)
2002 State Statute ❑Yes This Section Applies
The replacement of a Residential fixture or ap�liance that meets��.11 three of the following requirennents:
1) T7oes not require modification to electrical or gas:service.
2) Has a total cost of$SOO.OU or less;, excludinQ the cost of the f.txNre or appliance:
and
3) Is improved, installed or replaced by the homeov�mer or licensed contractor.
Skip next section; Cost of Permit $ 15.00
State Surcharge$ .50
Mail-In Fee $_ 1.50
If above does not apply,follow guidelines below:
1. Contra�t P�ice� is.O125%of job with a Minimum Fee of(��3S.OQl
�/� �/� ,�x.01?5 $ .�i�r c�C
�
�(conaact price) (minimum$35.0�)
2. State Surchar�e. ** Add the State Building Code Division a DJiinimum�'ee of($_.50)
_ �/L� `/.� Mx.0005 $ :�• j L
(contract pricc) (minimum$.50)
3.Posta�e and Hahdlia�(Only mail-in applicaiions) $ 1.50
CJ�
4.TOTAI.PERMIT FEE (Add lines 1-3 above) $ �. /.
�CONTRACT PRIC�or JOB COST means tha actual or estimatcd dollaz amor�nt charged for the perntit[ed work inciuding�
macerials,Iabor,profit,and oCher tixed eosts.It is the amount to bc chargcd to t he customer for the work done.Tf any material,
cquipmcnt,labor,or instAllation is flimished by thc owncr,tenant or any other�>arry[he retuonablc market value of Sueh i[ems
must be added to th:es:iTr:ated cos:�r convact price fo;pe:rnit:ee;,::r�cses.:;�ihc evt�:t that th�ro u a dispu::on tFe a.:,ou�t o.
the job cost,the Ciry may request che suhmission of a signzd�:opy ofthe ac[uai contract.
■'�Thc STATE SURCHARGE is.00OS of tht contract price wider$1,000,000��r$,50-whichever is grcater.�or valuations over
S1,OOO,tl00 call the Dcpnrtmcnt of Inspectional Scrvices for tl�e price.
TT�e undersigned hereUy applics to the Ciry for issuance of a Mechtulical Permi�,agrees to do all work in suic[3ccordance with
the ordinattces of the Ciry and the regulations of the Minnesot�Sta[e Building(�odc,and certifies that all statements madc on this
Applicacion Are eomplete,true and correcc_
Applicant's Signature: �-�-- � �"��,�_._ Date: — C7c-
Approved 8y: bate:
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Feb-25-2002 03:43pm From-CITY OF ORONO +9522494616 T-752 P.003/006 F-491
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Sec.13.04 RIGHT'S OF'SL�3.J£CTS OF D.i'CA
Subd. 1. rype o[data. Thc righu oF individua!oo whom the daa is srnce��o�w bc swRd shall be as sec[orih in ehis secrion.
Subd.2. Info�nali4n teqtured to be pvw(Adiridval. AA individual�slced lo supply priva�e or eonfidentui dan concetning himsdf ahall
be informea of: (a)�he purpose aad inmaded use o(���quasv.�i d«a wiehlia�t+e coUe,:dng Snrr ageary,potidcal subdivisioa,or smt�wide�sum;
(b)whuber he may�zfuse or is legally rcquired m supply the►equared dam;(�)�Y�w�a coosequenee uising from his ivpP�yiog ar tefusiog to suPP�Y
, private or eonCdendal data;and(d)rhe idcndty of othcr persons ar eneiaes au�harizcd by:ictc o�fcderal law to receive�e dan. ?his�equiz+emenc shall
aot apply whea an individu3!is askcd to suPPly invesdgaave data,p�irsuanc ro sceGon�3.82,svbdivisiou 5,to a law caforteuuat otficec.
'ilfe eartunissjoner of revenue mav olace the nodee repuired undeC this subcyivision in che individual ineome rax or vrov�m_tax_rcfund
�nsttucdo�s insread of on those fonns. � • -
Subd.3. Access to data by iadindual. Upoa rcquest to a rospansiblc autho�iry,an iadividual shall be info�med whe�her he is�e subjecc
of stor¢d data on individuzls,and w6e�her i�is cl�ssiFied u pu6lic,piivacc or conFd�nwd. Upon his fu�shcc roqucsG an iadividual w110 is the svbjeu
of sw�ed privare or public data en i¢dividuals shaU be s6owa thc dau wi�ftou�any charvto to hi�n aad,-U he desices,shsll ba infacmed af thc coatcat
and meaait►g of thac dara. Afur an iadividu�l has been shown d�e p��are dao and inforraed ef ia mcaning,thc dara need no�6e disclosed to 6im for
siz months dtereaher uNess a d'upure or accon pursuanc m this secc��n is pcoding oc additioaal da�on►he iadividusl has boon couceoed oc ereared.
llie responsble auchori�y shall providc copics of Ute privatc orpu6lie dan upon nquesc t�/thc individual subjea oC the da�. 'Ihe responsib�au�horiry
utay�tqu��e requcstiAg pecson to pay thC ictu�cos�oP makiag.cc�tifyi�.and cnin�il.ing dte copics.
The responsiblc authoriry shall eompiy iauiudia�ely,if po:siblc,wieh aqy rcQuest made pursuant to this subdivuivn,or withia five days oP
the daie oP the rcquesc,excluding Saturdays,Sundays and Icga1 holidays,if imiacdiate cornpl�ancc is natpossibla Ilhq canno�comp�y wi�h ttu�sques�
wiehin thac da�c,he shail so inforra thc individual,and may havo an zctdiaonal five days uri�in which to eomply wi��he teques4 exdudiag Sapudays,
5undayS and legal holidays. •
Subd.4.�R�aecdure�rhea data is nat accurate or cqmpl�_te. An individual�t�ay eoo�est thc aecu�aey or eompleeeness of publie or pri�acc
dats eonccming himself. To czcreise rh(s righG an individual shsll nodfy in wrien8 thc n.sponsible au�hority dacnl�ing the naaire of the dlsagreemen�
7ho responsble authoriry shall wirhin 30 days eidte� (ap ca�cec[�e da�a found ro be in.�ecurate or incomplece and aaempc ra nodPy p�recipicna oE
inaccurate or incompk�e dara,ineluding[ncipien�s named by ihe individuel;or(b)nodl"y the individual that hc believcs thc dala to bc eor�ec� Da�
in dispuoe shall be disclosed aNy if du individusl's statcment oE disagrceroent is inetud•�d wi�h the disclosed da�a.
?he decemut�adon o!du rapon�ible au�horiq tnay bc appenled pursuaat oo�the provisions of tha adminisuadve procedum acc nlaoag w
conoosred eases. •
DATA PRIVACY ADVI ;t�RY
In accordance with M.S. 13.04,Subd.2, "Rights of subjec�s of daw a",we would like to inforsnyou that your request
foc a pernut or license from the City oP Orono or aay of iu departme�its may require you to furnish certain private or
confideatial information. �
You are notified that: '
1, The informa[ioa you furnish will be used to de�ermine yoe�.t qualification for the permit orlicense requesced.
2, You may refuse to supply data. but refu:�al may require that [he Ciry deny the permit or license.
3, The information may be shared with other local, state or I'.ederal agencies to the ezteat necessary [o pracess
[he aermit or license.
4. If y0ur reques[ed pennit or license requires Councii ac�ion to approve, some infonnativn �ay �::.ca�e
public.
�, You have cenain rights under M:S. 13.G4 (availabte upon reques�) to review privace data ou yourself.
6,� Your full name is required to process this application o��permit.
���-��- � �
First M�ddle �t
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Address
��/� l ti ; c = r��-= _. �s:.�c� % 7�.� y-Oc��n
Ciry Sm�e Zip Phone
I understand my righcs as st3ted above. ,
C:� � �� ._
4
$I R1tG
i
DATE TIME
CITY OF ORO O g�`�� ALLED IN
INSPECTIO NOT SCHEDULED
PERMIT N0. COMPLETED ��
ADDRESS
OWNER CONTR. �,��_ �_C'�1 .
TELEPHONE N0. � �D� —��� 'C O��
� DESCRIPTION ,L �
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/G ADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATIGN 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 P�UMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERfCONTRA R TO ET _Y S
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� COMMENT : �` � � �� �
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W� ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W �OflRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� O CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (g52) 249-46�0
OwnerlContr or on site:
Inspector.����, �- , �
White Copyllnspector's File Canary Copy/Site Notice