HomeMy WebLinkAbout2015-00256 - mechanical CITY OF ORONO * Z 0 1 5 - 0 0 2 5 6 *
` 2750 KELLEY PARKWAY DATE ISSUED: 03/02/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 2605 MAPLERIDGE LA
PIN : 21-117-23-21-0005
LEGAL DESC : SHORE HILLS
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 5,700.00
NOTE: MASTER BATH REMODEL-MOVE EXISTING SUPPLIES AND ADD DUCTS AS NEEDED.
MOVE EXISTING AIR CONDITIONER AND RE-INSTALL.
(2)BATH EXHAUST
APPLICANT MECHANICAL 71.25
STATE SURCHARGE MECH(VALUATION) 2.85
RAY N.WELTER HEATING CO MAIL-IN FEE 2.00
4637 CHICAGO AVE
MINNEAPOLIS,MN 55407- TOTAL 76.10
(612)825-6867 Payment(s)
CHECK 029361 76.10
OWNER
PAULSON,ERIC
2605 MAPLERIDGE LA
EXCELSIOR,MN 55331-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved p(ans 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 type 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 180 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 aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
, oLl �l /J
Applicant Permitee Signature Date Issue By Signature Date
�O CI Y USE ONLY �
` 0A�� City of Orono _ . . m.:"� l--'— �_� �) c 2
� `�' P.O.Box 66 " " `� `'�Y Date Recei .� �j Permit fF�`f/�J �
��;; � 2750 Kelley Parkway
a 1��,r�. � Crystal Bay,MN 55323 t Approved By: Amount$:
2OQ5
�� �?��t�r'j4�$o`� Phone(952)249-4600 Fa�)�4�46]6
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CITY OF`�-OR�O�TiO=�NT�CHANICAL 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 pernuts by mail or in person at the City offices. Applications will
be reviewed and a permit will be issued within two working days.
2. Pernut cards will be sent by return mail after a review is completed. PERMITS f1RE 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. 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 Uniform Mechanical Code/State Building Code
requirements.
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 fmal.
TYPE OF PERMIT
(Check All That Apply)
esidential ❑ Commercial(Approval Required)
❑ New ❑Additional ❑ Repairs [��eplace
Job Site / Owner Information:
Site Addre : r L-i/1� j�� � � f�l�f��
G(,Ja 7a � /
Owner: U� �, St�V� ' �I,J� �; ��;�',Mailing Address: ` ,/ n� r�/� ;� j�I�G�
��t� I
City: ��-� � _ Zip: �L'VY�Y�=i n;� A�A� ��l�,S
Hoine Phone: Alternate Phone: ��o����y- ��L/�
Contractor Information:
Contractor: '� �U� <1�,�� Contact Person: %�Y�r
,
L
Address: Z{�3�) Ulk I�p� i:, � State Bond#: �1 IS D v .� I C�� �
, �s����� , � ��
City: l,j Zip: Expiration Date: � � � , ��t
Phone: � �%������'��'(�� AlternatePhone: �o��,� �� \ � ��''67
: ❑ Insurance-Current: 1,��
1
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Note:All Geothermal Systems will now require a Site Plan &Review by our Building Official.
IS THIS GEOTHERMAL? ❑ Yes ❑No �� - " o
HEATINGSYSTEMS I�IAS��J�-i�`,��J,f f�n1d'(7G�'�.—"��✓� e�/ b�.%A�6 �l�p�'�����
�bd I��c�s �yf -,UL'�'b�rJy
Quantity:
Make:
Model:
� Fuel:
Flue Size:
Input BTLTs:
. Output BTUs:
CFM:
COOLING SYSTEMS � d�� �,i s j/�� �j� �D��� T'/���, �' � ���Sr,I���
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Fireplace _
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILATION � . '
❑ No. Kitchen Exhaust duct recirculating cfm
� No. � � Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locarions cfm
FLJEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside �
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
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❑ Yes,this section 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 Pernut $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
,�-"�,x��«�.����t �'�,'�'���P�.�1��,� � S �'��`` �,:! ,��".���•,�'�aYi,�.''� ��Sh� �� �� �'��--:s'�� "�,.�,n'.-
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If above does not apply; follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
5, 70U� J �
� X.oi2s $ 7✓, d� �.
(contract pnce) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$5.00)
�7, vU� �' X.000s $ �.g� ✓
(contract price) (minimum$5.00)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 �
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �lp �
■ * 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 pemut fee purposes. In the event that there is a dispute on the
amount of the job cost, the Ci'ty may request the submission of a signed copy of the actual contract:
■ **The STATE SURCHARGE is .0005 times the Contract Price or a minimum of$5.00.
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The undersigned hereby applies to the City for issuance of a Mechanical Pernut, agrees 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 statements made on this application are complete, true and '
correct.
. p„ . �
Applicant's Signature: Date: r ���'1� ��
� 3
`—' D ��=� DATE TIME
CITY OF ORONO CALLED IN '
INSPECTION N TICE SCHEDULED 3�/e2/S .'0't7
PERMIT NO. '� MPLEfED
ADDRESS �
OWNER T EPHONE N ' 7 '
CONTRACTOR
� DESCRIPTION �'��L�� (J —
W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑�TIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERIC RA YOU: �NO
ti COMMENTS:
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W� RKSATISFACTORY:PROCEED ❑PROJECTCOMPLEfE
W RECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
� CO RECT VYORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CdVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pH0T0 TAKEN
INSPECTOR W{LL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 ho rs in advance. ) 249-46��
OwneNContraator on site:
Inspector:
White Copyllnspector's Ffle Canary CopylSke Notke