HomeMy WebLinkAbout2017-00643 - mechanical • � CITY OF ORONO * 2 0 1 7 - 0 0 6 4 3 *
2750 KELLEY PARKWAY DATE ISSUED: 06/14/2017
ORONO,MN 55356-
(952) 249-4600 FAX: (952 249-4616
ADDRESS : 129 CHEVY CHASE DR
PIN : 36-118-23-41-0020
LEGAL DESC : HILL O'WAY MANOR
: LOT O15 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : COOLING SYSTEMS
VALUATION : $ 4,000.00
NOTE: (1)DAIKIN A/C-3 TON
APPLICANT MECHANICAL 50.00
AIR RITE HEATING AND A/C INC STATE SURCHARGE MECH(VALUATION) 2.00
6935 146TH STREET W#3 �IL-IN FEE 2.00
APPLE VALLEY,MN 55124- TOTAL 54.00
(952)683-1900 Payment(s)
Minnesota State License#:mech-MB005390 CHECK 1056 54.00
OWNER
SAHLSTROM,DAVID&JEAN
129 CHEVY CHASE DR
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 dces
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 hereia 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.
� La� � � � ��
Applicant Permitee Signatur Date Issued ignature Date
•_ � � � FOB�CITY USE O�'LY
�O�O City of Oro�ECEIVED p.� �
P.O.Box 66 Datc Receivcd: Pern�it# Q�Q/�(/U
2750 Kelley Park��a�
Crystal Bay,MN��}��3� � ��'��% Approved By: Amount�:__�`�_
Phone(952)249�04� �x(9�5 _�9-4616
.d �.
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y`� �' {���"'�NNO— MECHANICAL PERMIT
19kEs�0�`�`
,� _� (All Commercial permits must be nppro��ed hy the Buildin�Ofticial or lnspector ancUor Fire Marshall)
GENERAL INFORMATION
L 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:VOT 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 ealculation,design temperatures,equipment ratings and identification as to
type,manufacturer and model. Data shall be presented on fonn 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 bc submitted before fina(.
TYPE OF PERMIT �
� (Check All That Apply)
�Residential ❑ Commercial (Approval Required) [Backflow Device: ❑ AVB ❑ PVB]
❑ New ❑Additional ❑ Repairs �'Replace
Job Site/Owner lnfornlation:
Site Address: f c� C i � ��T(�iT�.�% �-�,"
{
Owner:�l�Gi�/(=' �T y., ���'�..��,;,;` Mailing Address: �-;t S'f� (-�E .
r-.
City: ( ,��',��d-.z____r„ Zip: �� <?�'j
Home Phone: ��/o.� — J ri) c�yC!�lternate Phone:
Contractor Informatian:
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Contractor: H��j , r- �,� Contact Person: I "
Address: (�� ?j - �t���` i� C;J't�State Bond#: j�f���G�.S��;��
City: Zip: `�S�, �� Expiration Date: ��0�''_
Phone: ���� - �����<)�1 :� Alternate Phone:
,
Q Insurance—Current: �" ? '� ��
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,
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, G��,� ����% _M�:CHAI�I�AL SY S I'E>MS BEINC'T 11�`ST�1.,LLL� _
�____ __�_�____I
Note: All Geothermal Systcins will now requirc a Site Plan& fZeview by our 13uilding Ofticial.
1S THIS GEOTHERMAL? ❑ Yes �No
HEATING SYSTEMS
Quanrity:
Make:
Model:
Fuel:
Flue Size:
ingut BTUs:
Output BTUs:
CFM:
COOLiNG SYSTEMS
Quantity: �
Make: j�t-�, ��1
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: Locations cfm
FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑lnside ❑Outside
LP Gas: gallons
Other:
GAS LiNE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
1. CONTRACT PRICE * is L25%of contract price with a(Minimum Fee of$50.00)
F -
/��(`;.�:�� --� x .0125 $ )��, �`_
(contract price) (minimum$50.00)
2. STATESURCHARGE `�
�-I�C.i1 " x .0005 $ �}C •
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TO"['AL PERMIT I�'EE(Add Lines 1-3 Above) $ j�-�J �
• * 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. lt 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 amouni
of the job cost, the Ciry may request the submission of a signed copy of the actual contract.
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.
Applicant's Signature: ` Date: �i����% �
7 ,r,
3
���
DATE TIM
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED �_ �o:o0
PERMIT NO.a-dI�1"'O�(e`{'� COMPLETED
ADDRESS
OWNER T HONE NO. �(��',.90 290(0
CONTRACTOR �
�'' DESCRIPTION
❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ��AECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
i dWNERlCONTRACTOR TO MEET Y�U:_YES_NO
� COMMENTS:
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W ❑WORK SATiSFACTORY:PFiOCEED ROJECT COMPLEfE
W �.OR ECT WORK�PROCEED �I CERTIFlCATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COA/ERIN(i PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
O�wr�IContractor on sNe:
Inspector� /�.•� 7tt—
White CopYAnspector's File Canary CopylSit�Nodee