HomeMy WebLinkAbout2016-00138 - mechanical � CITY OF ORONO * 2 0 1 6 — 0 fd 1 3 8 *
• 2750 KELLEY PARKWAY DATE ISSUED: 02/10/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 780 NORTH ARM DR
PIN : 06-117-23-43-0010
LEGAL DESC : AUDITOR'S SUBD.NO.362
: LOT 007 BLOCK 000
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 3,000.00
NOTE: REPLACE HEATING SYSTEM(TRANE)
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.50
KNIGHT HEATING&AIR COND MpIL-IN FEE 2.00
13535 89TH ST NE
OTSEGO,MN 55330 TOTAL 53.50
(763)2749945 Payment(s)
Minnesota State License#:mech-MB003103 CREDIT CARD 9945 53.50
� OWNER
CARLSON,JEFFREY&KELLEY
780 NORTH ARM DR
MOUND,MN 55364-
AGREEMENT AND SWOR1�1 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 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 herein.This permit will
expire and become null and void if construction authorized is not
commenced within ISO 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 requved inspections aze
requested in conformance with the State Building Code.This permit may be �
revoked at any time for due cause.
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Applicant P rmit e Signature ate Issued By Signature Date
� FO�TY US�UNL`Y
�O� City of Orono
P.O.Sox 66 n�E��Ev�a: �a It t�P�„�# � - l
� 2750 Kelley Parkway �(r� �g
Crystal Bay,MN 55323 AppmvedBy: �✓ qn�p��g; �� . ,
P6one(952)249-4600 Fax(J52)249-4616
���� ��'� CITY OF ORON -
kFSHo� ! MECHANICAL rERMIT
(All Commercial permits must be approved by the Buitdrng Official or Inspector and/or F've Marshall)
GENERAL IN��RMATI4JN
1. You may apply for mechanical pemuts by mail or in person at the City offices. Applicarions will
be reviewed and a permit will be issued within two working days.
2. Permit cards will be seni by return mail after a review is completed. PERMITS ARE NOT
VALiD UNTIL YOU RECETVE A PERMIT. WORK MUST NOT BEGIlV UNTIL THE
PERMIT CARD IS POSTED ON THE JOB S1TE.
3. Mechanical Desi¢ns—Complete calculations,details and specificarions are required for each
heating,ventilation,humidification-dehumidification,and air condiUoning installation including
heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to
type,manufacturer and model. Data shtill be presented an form provided.
4. When any new construction or remodeling is involved,a separate bwlding 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 fina]). Call(952)249-4600.
(24-48 haur notice required)
7. House Heating Test Record must be submitted before fi.nal.
TYPE OF PERIVIIT
Check All That A 1
�Residential ❑Commercial(Approval Required)
❑New ❑Additional ❑Repairs �Replace
Job Site 1 Owner Lnfc�rmation. '
Site Address: ��� �01-� �1� ,�}-���
Owner: V�� ��.#'!�-�'�'7 Mailing Address: ��(„�„/t/�i�! ,�j"rJ'I�Y�v�_'.
c�r�: �YDna , I'1.�1 N z,p: ..5"s3lv�
,
Home Phane: �lJc�'�-°J�--���(� Alternate Phone:
Contractor Information: ;
Contractor: ��� Q17�Contact Person: lJ��� U�'-�
A��-�c��fir�n� , :��c .
Address: f����i --�5'��i �„�i�State Bond#: �/1���(��j
� 9
City: Zip:.J�`�J3-�' Expiration Date: T/r'/--�/(p
Phone: ���."��-��� Alternate Phone:
❑ Insurance-Current: ��r{,{l'�
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Note:All Geothermal Systems will now require a Site Plan&Review by our Building(Jfficial.
IS TAIS GEOT�IERMAL? ❑Yes �No
HEATING SYSTEMS
Q,��ri: �
Make: _J�� � —
Moc�el: f Gl(�l G ll�l�f��,�'i�
FueL• t�' �S
Flue Size:
Input BTUs: !���/ v U (,.�
4utput BTUs: _�_ )(�
CFM:
CQOLING SYSTEMS
Q��ty� �
��:
Model:
Tons:
H.Power
FIREPLACES
❑ Cias Factory Fireplace Brand Name:
❑ Wood Buming Fi.replace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) ��
❑ No. Other Fans: Locations ��
FUEL STORAGE (Must be appraved by Fire Marshatl if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gailons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdaar Grill ❑ Other/List What&Where:
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51� �'t�:w,�9:�rt.r k' q,�.-'�;.�.��� � � u4� ��.:a '�i�.'�-'���':��'S.::s;--.��;��- iz'�§'°�.+�'�
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
..�C�"t�2�, �'+�
X.oizs� ��. �
(conttract price) (minimum 550.00)
2. STATE SURC1iARGE �,�-A.�{ �, �,_-�l
il(l t! x.0005 $ . � {J
(contrect price}
3. POSTAGE&�IANDLING(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 doilaz 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 materiat,equipment,labor or installations are fizmished by the
owner, tenant or any other party, tbe reasonable market value of such items must be added to the
estimated cost or cantract pzice for permit fee purposes_ In the event that there is a dispute on the amount
of the job cost, #he City may request the subr[ussion of a signed copy of the actual contract.
4���3AFi� k. W� q� � " ...t > -`k`y� �6 'J-�
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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 regulstions of the State of
M'innesata,and cerrifies that all statements made an this application are complete,true and conect.
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Applicant's Signature: _��_ Date: r��"
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