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Home My WebLink About2015-00121 - mechannical � CITY OF ORONO * z 0 1 5 - � 0 1 2 1 * " 2750 KELLEY PARKWAY DATE ISSUED: OU27/2015 ORONO, MN 55356- 952 249-4600 FAX: (952) 249-4616 ADDRESS : 25 MYRTLEWOOD RD PIN : 36-118-23-33-0014 LEGAL DESC : MYRTLEWOOD : LOT 002 BLOCK 002 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : MECHANICAL-MULTIPLE VALUATION : $ 17,347.00 NOTE: 1 HEATING SYSTEM, 1 COOLING SYSTEM, I HOOD VENT,3 BATH EXHAUSTS,GASLINE TO STORE&DRYER APPLICANT MECHANICAL 216.84 STATE SURCHARGE MECH(VALUATION) 8.67 RICCAR HEATING&AIR COND INC. MAIL-IN FEE 2.00 2387 STATION PKWY NW ANDOVER, MN 55304 TOTAL 227.51 (763)754-4000 Payment(s) CI-IECK 227.51 227.51 OWNER RYAN, STEVEN&ANNE 25 MYRTLEWOOD RD WAYZATA,MN 55391- 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 does 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 l80 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 permit may be revoked at any time for due cause. 7 � �/ , i � ' j,�� _ � �� ,ti'�,C� � � l � �`'�7, l S Applicant Permitee Signature ate Issued By Signature Date ' FOR CITY USE ONLY �� City of Orono P.O.Box 66 Date Received: Permit# 2750 Kelley Parkway Crystal Bay,MN 55323 Approved By: Amount$: Phone(952)249-4600 Fax(952)249-4616 .� a, ti � � �. CITY OF ORONO—MECHANICAL PERMIT ��KFS�� (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL INFORMATION 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 two working days. 2. Permit cards wifl 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. 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 final. TYPE OF PERMIT Check All That A 1 Residential ❑ Commercial(Approval Required) ❑ New ❑Additional ❑ Repairs [✓�Replace/�7�.(Y�16� � l Job Site/Owner Information: Site Address: �� f��U��,u r(�� , Owner: � Mailing Address: c�Ty: �y�: r�b tj��_ z�p: Home Phone:l(�� —�[� �CJ`C�� Alternate Phone: Contractor Information: � Contractor: RICCAR HEATING&AIR Contact Person: I I� 1�' 1e� � 6� ��- - 81 STATION PARKWAY N.W. �g Address: ANDOVER,MN 55304 :. State Bond#: �Y��0�3L-�'��' City: Zip: Expiration Date: _�� Phone: Alternate Phone: ❑ Insurance—Current: — �, 1 C��I�-�� MECHANICAL SYSTEMS BEING INSTALLED Note: All Geothermal Systems will now require a Site Plan& Review by our Building Official. IS TffiS GEOTHERMAL? ❑ Yes [�No HEATING SYSTEMS Quantity: / Make: ModeL (� ! ��'—f' l Fuel: Flue Size: � I❑put BTUs: [�j(J U v Output BTUs: l � 7� CFM: � COOLING SYSTEMS Quantity: / Make: Q Model: �� /�� ' Tons: H. Power FIREPLACES ❑ Gas Factory Fireplace Brand Name: ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTILATION ��./C� ❑ No. l Kitchen Exhaust 6�uct recirculating cfm � Na � Bath E�chaust(must have duct outside) �cfm No. Other Fans: Locations cfm FUEL STORAGE (Must be approved by Fire Marsha[!if proposing to abandon tank in place.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑Outside LP Gas: gallons Other: GAS LINE ONLY f ❑ Outdoor Grill � Other/List What&Where: ��(11� � �� 2 �� PERMIT FEE CALCULATION(S) BASED OFF -2002 STATE STATUE ❑ 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;excludinQ 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 Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 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$50.00) I� � x.0125 $ . 0 L contract price) (minimum$50.00) 2. STATE SURCHARGE /�J' ��/� Q-� x.0005 $ �• C� � � / / -�(contract price) 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 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 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. 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 City and the regulations of the State of Minnesota, and certifies that all statements made on this application are complete, true and correct. i / � � Applicant's Sign r . Date: ��^ l 3 �� RICCA-2 OP ID:KNEL `�`.�'�p C E RTI F ICATE O F LIAB I LITY I NS U RANC E DATE(MMIDDIYYYI� 03/24/14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED �+EPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. .1PORTANT: If the certlflcate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the tertr�s and conditions of the policy,certain policies may require an endorsement A atatement on this certiflcate does not confer rights to the certificate holder In lieu of such endorsement s. PRODUCER 7G3�Y9S-EOOB �EACT Liberty Insurance Agency P�E MonUcelto o exc: ac No: 1560 Hart Boulevard o��ss: Monticello,MN 55362 Randy Hadaway INSURE S AFFORDING COVERA(iE Nac# iNsur�an:West Bend Mutual INSURED Riccar Heating 8 Air INSURER B: Conditioning,Inc. INSURERC: 2387 Station Parkway NW Mdover,MN 55304 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WH�CH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TypE OF IN8URANCE POLICY F P ICY LTR POLICY NUMBER M MMID LIMRS GENERAL LIAB�ITY EACH OCCURRENCE $ �,OOO,OO A X COMMERCIAL GENERAL LIABILITY X BC01844519 04/01/74 04✓01/15 pREMISES Ea occunence S 20�,�) CLAIMSMADE �OCCUR MED EXP(Any one peraon) $ 1 O,O X Blkt Add'I Insd. PERSONAL 8 ADV INJURY $ ��0�� WB��H2 GENERALAGOREGATE $ 2�000�00 GEN'l AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ Y,OOO,OO POLICY X PRa LOC Emp Ben. S 'I,OOO�OO AUTOMOBILE LU161LfTY COMBINED SINGLE LIMIT Ea acclaent 1,000,00 X ANY AUTO BC01844519 �4/01/14 04/01/15 BODILY INJURY(Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per axident) $ X Fi1RED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ $ X UMBRELLA LIAB X ppCUR EACH OCCURRENCE $ 'I�OOO�OO A ��E$$�� CLAIMS-MADE CU01844521 04/01/74 04/01/15 pGGREGATE $ DED X RETENTION 'IOOOO $ WORKERS COMPENBATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY A ANYPROPRIETOR/PARiNER/EXECUTNE Y�N C01844520 ��/�4 04/07/15 E.L.EACHACCIDENT $ 5�,�� OFFICER/MEMBER EXCLUDED? � N I A (Mandatory in NFI) E.L.DISEASE-EA EMPLOYEE $ SOO,O Ifyes descxibe urMer DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ SOO�OO DESCRIPTION OF OPERAT10N3/LOCATION3/VEHICLES (Attaeh ACORD 101,Addidonal Remarks Seheduk,if more spaca Is requlred) CERTIFICATE HOLDER CANCELLATION ORON001 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CI�/Of O�OIlO THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P.O.Box 662750 Crystal Bay,MN 55323 pUTHORIZED REPRESENTATNE �,��-.:�-�> O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/OS) The ACORD name and logo are registered marks of ACORD _ , _ - _ - � ""'"""�`°E�"'�''£"'�°P .. ME�H°ANICAL CONTRACTOR`BQND .. �..a,so��e��[nus��v � `�.: Construction Cades and-�icensing Division Licensing�nd Certificatinn Services A43 Lafayette Road N St.Paul,MN 55155. VYebsite:'www dli:mn:aov/ccld.asu Email: dli:license[�state.mn.us ��.�..P,hone: 651284.503a , 'f�is';is to�ertify:that the cerEificate holder is�registered as a MECHANICAL COI�I�'RA�'POR�OND in the state of Minnesota and is in compliance "` wifh Minnesota Statutes 326B.197,and has filed a$25,OOU mechanical bond W perform gas;heating,ventilation,cooling,air condirioning, ; fuel burning,or refrigeratio�work�,:all areas;o��he staYe during the re�tration period;provided the work performed.comp]ies witt{. - - - , -_- the State Mechanical Code and the c.�ihficat�holder u��au�tat�s:.c�pltan�e with the r uued bond and workers'co ` - eq � nRpensarion laws. : --- --, _ . _.:- __ -_- \ � R�gistratiqn : MECHANICAL CONTRACTOR BOND." � Re�Nurraber : M�i003474 RICCAR CORPORaTION —� B E�fect}�ie D�te :'08/t�/2,014 DBA RICCAR HEATING AND AIR COI�DITIOI�ING � � , Escpiratior�Date : 08/15/2U16 2387 STATION PKWY NW ` c ANDQVER, MN 55304 . T YERIFY U.P-TO-DATESTATEl,S,BDNp,AN�INESURANCE-INE4_ATwww.dli.mn.aov/ccld/LicVerifv.asp (ENTER=NUM�ER).. _ ' �. � � �� DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTI E �r 7 � SCHEDULED � I CS � PERMIT NO. � ��' COMPLEfED ADDRESS � ��d d OWNER TEL HONE NO�� /� CONTRACTOR � DESCRIPTION �Q�-�'/`-'�j� 4� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING y ❑ FOUNDATION WATERPROOF n P�'�,'.^-,�F;NAL ❑ TREE REMOVAL Z ❑ RADON SLAB � ❑ MECHANICAL�� ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS '� � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT � Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP � � ❑ AS BUILT-SURVEY ❑ E R HOOK-UP ❑ HARD COVER REMOVAL � J ❑ DEMO-SITE �` PTIC INSTALL ❑ FOUNDATION/REMOVAL �` 2 OWNERICONTRACTOR TO MEET YOU: YES_NO ti COMMENTS: � � �� l � - F C�✓�'! ' d� o -- "a�h on �.�' G. �� a7:�rG -� °� - Sc t l .c<� �er�e_�r�to.r,s /�, fc?:u✓ K W � Q G��r C�v�f�a� - � z � �est k�Du�f OK - W � J d W� ❑WORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE �RRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECONERING PERMANENT ❑CORRECT UNSAFE CONDITION WRHIN HOURS. ❑pHOTO TAKEN INSPECTOR WILL RETURN O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REW IRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advaru�e. (g52) 249-46�� OMmerlContractor on site: 3 Inspector. Q/w— � ,, r '• White Copyllnspector'a�� '�—�"��C�op�ISMe Notiee ��►Pr a,d� �'�'t..�. 7 �6�+-�s � l `�� C� / ATE TIME J C OF ORONO CALLED IN (� 15 —�-�� INSPECTION NOTICE �/ SCHEDULED (�j'-�L=�� —�-=-r�-� PERMIT N�?��5��`�' COMPLEfED ADDRESS OWNER ONE NO. CONTRACTOR l�� ; DESCRIPTION � ll� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUM,BHVG FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ CHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION OOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEEf YOU:_YES_NO c�.� COMMENTS: � W C � J Of ,,, �r ,- � O � � W ,/• � �� Q � 2 W � W � � J a W ❑WORKSATISFACTORY:PROCEED ROJECT COMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ IS UE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORE CWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN �NSPECTOR W{LL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance (g52) 249-46�� OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice