HomeMy WebLinkAbout2016-01248 - mechanical -� CITY OF ORONO * z 0 1 6 - 0 1 2 4 8 *
2750 KELLEY PARKWAY DATE ISSUED: 10/03/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 440 NORTH ARM DR
P[N : 06-ll 7-23-31-0003
LEGAL DESC : VICTORIA ESTATES
: LOT OOl BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 3,400.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT F1NAL INSPECTION.
HEAT-N-GLO GAS FIREPLACE
APPLICANT MECHANICAL 50.00
SAND CREEK DESIGN BUILD LLC STATE SURCHARGE MECH(VALUATION) 1.70
3496 W 220TH ST TOTAL 51.70
JORDAN,MN 55352- Payment(s)
(952)994-6682 CHECK 5158 51.70
Minnesota State License#: BUIL-BC649608
OWNER
STERNAU, RENE
440 NORTH ARM DR
MOUND, MN 55364-
AGREEMENT AND SWORN STATEME1vT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State E3uilding 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 governing 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 are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause. �
,
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Ap ' t Per�' e ignature a Issued By gnature Date
' FOO CI Y USE ONLY
�O A TO City of Orono
1 V P.O.Box 66 Date Receiv�d: Permit# ��' ���
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By: Amount$:��`_�
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Phone(952)249-4600 Fax(952)249-4616
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`qk£SH�R� 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 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 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 Desi ns—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) [Backflow Device: ❑AVB ❑ PVB]
❑ New ❑Additional
❑ Repairs �eplace
Job Site/Owner Information:
Site Address: �/ ,(,i � �c,/
Owner:�� ���✓ Mailin Address•
g •
City: Q ci
ZiP� _ .�5 �s,4-
Home Phone: Alternate Phone:
Contractor Information:
Contractor: -� /, � ��ontact Person: �'I :
Address: �,� � 1,.2p7��j. State Bond #:
Cit '-'
Y� Zipf �53� Expiration Date:
Phone: �5?-J j� �i�— Alternate Phone:
❑ Insurance-Current: ����j
1
,. .
Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes ❑No
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
Brand Name: '+ �L�
� Wood Burning Fireplace
� Wood Stove Model No.:
� Wood Stove with Flue/Masonry
VENTII..ATION
❑ No. Kitchen Exhaust duct recirculating c�
� No. Bath Exhaust(must have duct outside) c�
� No. Other Fans: Locations
FUEL 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
PERMIT FEE CALCULATIONS
1. CONTRACT PRICE * is 1.25% �f contract price with a(Minimum Fee of$50.00)
��d
x .0125 $
(contractprice) (minimum$50.00)
2. STATE SURCHARGE
x .0005 $
(contract pdce)
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 far 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 conri-act.
MECHANICAL PERMIT APPLICATION AGREEMENT
The undersigned bereby applies to the City for issuance of a Mechanical Permit, agrees to do all
wark 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,tru�nd correct.
Applicant's Signature: � � Date: � / C�
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�� �.�� �/ DATE TIME
I CITY OF ORON�``V'�' �'°��� cALLED IN
INSPECTION scHEDULED � �
PERMIT N COMPLETED
ADDRESS � � � � ��� r�
OWNER TELEPHO E NO.�'��``l�`1 ��
CONTRACTOR C- C �
� DESCRIPTION '/� �— C _ ((�_ " 'I�
ly ❑ FOOTING ❑ DEMO-F4M�L ❑ SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FO DATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ ADON SLAB ❑ CHANICAL RI ❑ SITE INSPECTION
Q FRAMING ECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OMINENICONTRACTOR TO MEET YWJ:_YES_NO
y COMMENT'S:
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W K SATISFACTORY:PFiOCEED ❑PROJECT COMPLETE
� RRECT VMORK a PROCEED ❑ISSUE CERTIFICATE OF OCCUPVINCY
W
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPOFiARY
V BEFORE CdVERINd PERMANENT
❑CORRECT UNSAFE OONDITION WRHIN HWRS. p pHpTO TAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOH U CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
can ro��r,��ext��24 no�,�in aa�►a�. (952) 249-4600
ownerlContractor on site:
Ins�...., i ^— .
Whits Copyllnspecto�'s Fils C�nary CopyfSlb Notice