HomeMy WebLinkAbout2003-P06516 - mechanical CITY F R PERMIT
� � �N� Permit Number:
27�? Ka�iey Parkway- PO Box 66 P06516
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Pernuts
(952) 249-4600 Date Issued: ��s�2oo3
SITE ADDRESS: 165 Luce Line Ridge
Maple Plain,MN 55359
P I D: 31-118-23-34-0008
DESCRIPTION:
Proposed Use: Residential
Pernut Class: General
Pernut Type: Mechanical Permits Pernvt Sub-type(s): Air Condirioning
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: PermitFee: $ 40.05 Valuation• $ 3,204.00
State Surcharge Fee: $ 1.60
Misc.Fee: $ 1.50
TOTAL FEE: $ 43.15
APPLICANT' Residenrial Heating&Air,Inc.(See Comtr OWNER' Mr.&Mrs. Church
� 1815 East 41 st Street Suite A � 165 Luce Line Ridge
Minneapolis,MN 55407 Maple Plain MN 55359
T'HE 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 SI'ATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMI'fEE SIGNATURE ISSUED BY SIGNATURE
Covies: 1-File(SiQnitures Required), 1-At�plicant, 1-Monthlv Renorts, 1-Assessin�, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT �=: , �;
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323 :�
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GENERAL INFORMATION 4�'
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1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be �°
reviewed and a permit will be issued within 2 working days. 'fi
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. �lechanical Designs - Complete calculations, details and specifications are required for each heating,
ventilation, humidification-dehumidification, and air conditioning instaliation including heat loss/heat gain ''y
calculation, design temperatures, equipment ratings and identification as to type, manufacturer and model. '�
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Data shall be presented on form provided. Identification of and specifications for water heating equipment �c
snall also be providea�'
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 473-7357. 24-hour notice required. �f
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7. House Heating Test Record must be submitted before final. ;i;
Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification. '
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 473-7357. �
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Please check one: Addition Repair v Replace ��
- Residential Commercial `� ti
JOB SITE: ►L�_5 1 ��•�(� L�N C. �`�U� Zip: ,;'
Owner's Name: �;�.����N,.L CN�,.r���+ Telephone Number: ���2- yq �S - 1 S 15
Mailing Address: t C 5 L�c c-. L� �� y2�o���ity: �,�� � C Zip: �:�
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Contractor's Name: tZ c_5 � �E��..�� F�}ER���� r,�}���Telephone Number: E;z- -7z y - r SS q� '
Mailing Address: !X�.5 e" - �t 5 S�- .S c„-�z:q- City: � P�s Zip: 5 5�-t 6 � �
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SYSTEM DESCRIPTION � � `
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HEATING SYSTEMS '�'`
QU�;1�1ty': ,
Make: `
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs: j��
CFM: �
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COOLING SYSTEMS
Quantity: � 'a'
Make: �c����
ModeL• /isyc r�5 p 6 �
Tons: S � � �
H. Power �
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WOOD BURNING EOUIPMENT
Wood stove with flue
Wood combination or add-on
Factory fireplace with flue
Factory Fireplace (s) Freestanding Masonry
Wood Stove (s) Franklin, other
Brand Name Model No.
Mfgr's Min., Clearances, side , rear , min. flue dia.
VENTILATION
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. _ Other Fans: Locations _ ___ _ _� cfm
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation Removal
Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
�Zc�'-�' ° x .0125 $ `�'0� �
. _._ _ (contract price) __. .___ ... .. __.
2. State Surchar�e. ** Add the State Building Code Division
Surcharge to each permit. �L o y- a`� x .0005 $ � �" b�
or $.50, whichever is greater (contract price)
3. Posta�e and Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ � � • �.�
* 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 cione. lT any material, equipment, labor, or ins�allation are furnisned 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 STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is
greater. For valuations over $1,000,000 call the Department of Inspectional Services for the price.
The undersigned hereby plies to the City for issuance of a Mechanical Permit, agrees to do
all work in strict accordan� with the ordina ces of iry and the regulations of the Minnesota
State Building Code, and c 'fies that all sta ents de on this application are complete, true
and correct.
Applicant's Signature: Date: 6 �Z�'0 3
Approved By: Date:
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