HomeMy WebLinkAbout2016-00749 - mechanical � ' CITY OF ORONO * 2 0 1 6 - 0 0 7 4 9 *
2750 KELLEY PARKWAY DATE ISSUED: 06✓27/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 1490 LONG LAKE BLVD
PIN : 26-118-23-33-0002
LEGAL DESC : LTNPLATTED 26 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : 1�CHANICAL-MULTIPLE
VALUATION : $ 7,821.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
APPLICANT MECHANICAL 97.76
STATE SURCHARGE MECH(VALUATION) 3.91
STANDARD HEATING&AIR CONDITIONING MpIL-IN FEE 2.00
130 PLYMOUTH AVENUE N.
MINNEAPOLIS,MN 55411- TOTAL 103.67
612-8242656 Payment(s)
CHECK 51559 103.67
OW1�1ER
BJORGEN,TRYGVE&BROOKE
1490 LONG LAKE BLVD
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 separate
permits. All provisions of laws and ordinances goveming this rype 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 I80 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 perrr►it may be
revoked at any time for due cause. �
._ l�� �;.`� �.c��I ��.�.�c� � �z �� j �o
Applicant Permitee Signature Date Issued By Signature Date
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CITY OF ORONO-MECHANICAL PERMIT
(All Commercial peimits must be approved by the Building Official or Inspector andlor Fire Marshall)
C GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City ofYices. Applications will
be reviewed and a pennit will be issued within two working days.
2. Pennit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT
VALID tJNT'IL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMTT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Designs—Complete calculations,details and specifications are required for each
heating,ventilation,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 construction or remodeling is involved,a separate building permit must be
obtained.
5. All work must be done in accordance with the Unifonr►Mecl�anical Code/State Building Code
requuements.
6. All work must be inspected(rough-in and fmal). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before final.
T'YPE OF PERMIT
Check All Tl�at A l�r)
�Residential �Commercial(Approval Required)
✓ �
❑Ne�� ❑Additional ❑Repau-s ❑Replace
Job Site/����ner Inforniation:
Site Address: � � ��� `-�� ��v
Owner: . 4� ai �ng Address: /� � �� "uV��
���
5
���: C��o Z�p: SS35
Home Phone: �S � ��� � l,��Alternate Phone:
Contractor lnformation:
Contrac�r�ndar � � ning Contact Person:
130 Plymouth Avenue North
Address: Minnea olis, MN 55411-3445 State Bond#:
61 -. �
City: Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance-Cunent:
1
, _�._.._.._.,z-�
MECHANIGAL SYSTEMS BEING INSTALLED
Note: All Geothermal Systems will no«�require a Site Plan& Review by our Building Official.
<
•• IS THIS GEOTHERMAL? ❑Yes �No
HEATING SYSTEMS
Quantity: /
Make: �
Model:
Fuel: G�,�
Flue Size:
Input BTUs: � �"�u _
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity: �
Make: �
Model: �
Tons: �r/Z
H.Power �(/ -�---
FII2EPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Biuning Fireplace
� Wood Stove Model No.:
❑ Wood Stove With Flue
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by Fire MarshaU if proposing to abandon tank in place.)
� Installation H Removal
Fuel Oil: gallons ❑ Un�erground �Inside �Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill � Other/List What�Where:
2
PERMIT FEE CALCULATION(S}
K BASED OFF -20t)2 STATE STATUE
[]� Yes,this section applies
The replacement of a Residential fixture or appliance that mcets all three of the following requirements:
1. Does not require modirication to electrical or gas service.
2. Has a total cost of$500.00 or less;excludin�the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Pennit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
PERMIT FEE CALCULATI4N(S)__JOBS 4VER 9��(}O.OQ �
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
� � x.0125$ �
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of�.50)
� �y 1 X.o�s $ 3 •�_
(coniractprice) (minunum� .50)
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 fumished 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 Yhe job cost,the City may request the submission of a signed copy of the actual contract.
■ **The STATE SURCHARGE is.0005 of the Building Department at(952)249-4600 for the price.
���"���.������"�r._��iIECHANICAL;PERMIT APPLICATIOI�T AGREEMENT °° �'���,�;
�¢
The undersigned hereby applies to the City for issuance of a Mechanical Permit, a�ees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all state nts de on this application are complete, true and
correct.
Applicant's Signa . Date:
�ly � � �
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