HomeMy WebLinkAbout2005-P09321 - gas line inspection PERMIT
CFTY Z�F ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P09321
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952)249-4600 Date Issued:
10/18/2005
SITE ADDRESS: 3554 Lyric Ave Unit#
Wayzata,MN 55391
PID: 17-117-23-43-0055
DESCRIPTION:
Proposed Use: Residential
Pemvt Class: General
Permit Type: Mechanical Pernuts Pemut Sub-type(s): Gas Line Inspection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Fix 4 leaks on gas system
FEE SUMMARY: Pernut Fee: $ 35.00 valuation: $ 800.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Gavic&Sons Plumbing&Water Specialri� OWNER: Dawn Stilnovich
(See comments) 3554 Lyric Ave
12725 Nightingale St. Wayzata MN 55391
Coon Rapids,MN 55448 /�
THE UNDERSIGNED HEREBY REQUESTS RMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN S T COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUI MENTS.
APPLICANT PE SIGNATURE SLTED BY SIGNATURE
Copies: 1-File(SignaturesRequired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
�
'�. . FOR CITY USE ONLY
' ,��� City of Orono
P.O.Box 66 bate Received: Permit#
�'� � 2750 Kelley Parkway
� > � � Crystal Bay,MN 55323 Approved By: Amount$:
t�,� ' o (952)249-4G00
'�R o�y
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CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical pemuts by mail or in person at the City offices. Applicarions will
be reviewed and a pernut will be issued within two working days.
2. Perxnit cards will be sent by retum 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 Desi�s—Complete calcularions,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air conditioning installarion 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 airy new construcrion or remodeling is involved,a separate building pernut must be
obtained.
5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code
requuements.
6. All work must be inspected(rough-in and final). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
Check Al1 That A 1
�Residential ❑ Commercial(Approval Required)
❑ New ❑Additional �Repairs ❑Replace
Job Site/ Owner Information:
Site Address: � L� y/� �V c
� y �
Owner: �a u� 5 f; �j r�,ov��.�,. Mailing Address: 35s`� Ly�;� r�e
City: �o v�� Zip:
Home Phone: �5�' ��v —�S�Z Alternate Phone:
Contractor Information:
Contractor: C���c. � �'^�� Contact Person: �y�
Address: I L� ZS �.f���^.� �f; State Bond#: � �1 ��06/I
City: K � ��s Zip: �y�Expiration Date:
Phone: G�Z �d 3 Z7�9 Alternate Phone:
� Insurance—Current: Ga�
1 �in`/�so►� ,j,,•.su�.�,�c� /�g�""'
�
MECHANICAL'SYSTEMS BEING INSTALLED V •'f
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
❑ Gas Factory Fireplace
❑ Wood Burning Fireplace
❑ Wood Stove
❑ Wood Stove With Flue
Brand Name: Model No.:
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUE�,STORAGE(MUST BE APPROVED BY FIRE MARSHALL)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
� � y ����5 0� S.� sy��,
❑ Outdoor Grill � Other/List What&Where: �x
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� PERMI'��EE CALCL�LATItON�S) ' `
� ° BASED OFF = 2402 STATE STATUE
❑ Yes,this secrion applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludine 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 Pemut $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $
PERMIT FEE<CALCULATION(S)-JOBS OVER$500.00 '
If above does not apply; follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$35.00)
�o��• X.0�25 $ � 35.o0
(contract price) (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S
■ * 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 done. If any material, equipment, labor or installations 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 Building Department at(952)249-4600 for the price.
` MECHANICAL PERMIT APPLICATION AGREEMENT
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 ty and the regulations of the State of
Minnesota, and certifies that all statements made this application are complete, true and
correct.
Applicant's Signature: Date: a
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