HomeMy WebLinkAbout1998-010593 - mechanical PERMIT
� 'VITY OF ORONO PERMIT TYPE: �.l�___�,�-,���i:�;�_
2750 Kelley Parkway- P.O. Box 66 Permit Number: ;�;�t_;:.�_�;;
Crystal Bay, Minnesota 55323
(612) 473-7357 Date Issued: i,;�;f��_#;_j;_;
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: — �:���s�. i r��-it. — OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATU E
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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 �� -
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1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be �`x'
reviewed and a permit will be issued within 2 working days. 1�:
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. 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. t ;�� �
Data shall be presented on form provided. Identification of and specifications for water heating equipment � � ` ,
shali alsa be provided.
4. When any new construction or remodeling is involved, a separate building pernut must be obtained. " "'``
5. All work must be done in accordance with the Uniform Nlechanical Code/State Building Code h ,�
requirements. �� b;
6. All work must be inspected (rough-in and final). Call 473-7357. 24-hour notice required. ,y
7. House Heating Test Record must be submitted before final. "��
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Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification.
b INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 473-7357. ' �
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� Please check one: New Addition Repair t/ Replace ��
� Residential Commercial '"
\ JOB SITE• - ' Zi r" 3 l � �. �'
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,� Owner's Name: � � ,� Telephone Number: �{7�- /,2� ��" �;;
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, Mailing Address: -, .��� City: Zip: � ��
�� Contractor's Name: � �' '�`�'`�= Telephone Number:
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Mailing Address: City: Zip: � ��
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c�� SYSTEM DESCRIPTION �`.;
- � � � , � ti ��
HEATING SYSTEMS
Quantity: f �'
Make: �� �l�'- — _
Model: _,��` ;�- � -�
Fuel: u,;, ��
Flue Size: �;; "
Input BTUs: �c'�v pp�}
Output BTUs:
CFM:
CQOLIN� SYSTEMS �
Quantity:
Make: l�c'm��i�/i�n ��j/�iy�eG =�
Model: "7A-�tTi_3�A /�>C R �
Tons: � ��''��
H. Power � r
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.;..�FS • . . . . r
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WOOD BURNING EQUIPMENT '= 4�4�h, ;:a,�, "r_r ,.;
Wood stove with flue �� ;�;�. ,y,�;,;a � �
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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%o of Contract Price* or Minimum Fee ($35.00)
�''tvG' x .0125 $ �d', 7S
(contract price)
2. State Surcharge. *�` Add the State Building Code Division
Surcharge to each permit. x .0005 $ � .�s
or $.50, whichever is greater (contract price)
3. Posta�,e and Handlin� (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 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 installation 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 pernut 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 applies to the City for 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 Building Code, and certifies that all statements made on this application are complete, true
and correct.
Applicant's Signature: �✓/ • Date: "7oZT -ri�
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Approved By: �`�; Date: � (�� �
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB NO. Y�l S S
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 • (612) 881-9000 TEST RECORD
ADDRESS 2�6J '�c� ��r tl C�<`� CITY C��� : !J
OCCUPANTf� .v���E��.}��•,! OWNER `"`�-,.
SOLD BY�., '��.a�- INSTALLED BY
MAKE ��.w� �" MODEL3�3 �I1 v Q6C� /OG
SERIAL NO.�`t /� �I G'-32 � INPUT I"(/!7 !�d O
.
THERMOSTAT �,a�� S �f�Ll VENT SIZE V ��
VALVE G�ti '�'-� �d C 'C✓f TYPE OF LINER 6"V"�; �
LIMIT �`���+"� LINER SIZE �o ��
LIMIT SETTING ��'/ ✓� FILTERS: SIZE Z f3 r1.S ���r u NUMBER �
FAN SETTING � `�m `-� � WIRING �����"► 3t'''
PILOT TYPE �frc,'�c"' Q TEST TAG �
IGNITION MODEL U��Ycn }- LIGHTING INST. �
PILOT TIMING CGn .�`��-c t
DATE TESTED -��'3"��
PRESSURE.j..S��'(.�'/� PERCENT COz _� ?�
INPUT CFH ��� PERCENT OZ 6 �� COMPANY TESTING ����.i ti�
STACK TEMP. ��-�� PERCENT CO 6 �� NAME OF TESTER Gt"1i�z G�v�x.�..� �
FORM 235(REV.11/89) FORM DISTRIBUTION: WHITE COPY-JOB FILE VELLOW COPV-CITY