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Home My WebLink About2016-01383 - gas line only ,� , - CITY OF ORONO * 2 0 1 6 - 0 1 3 8 3 * 2750 KELLEY PARKWAY DATE ISSUED: 10/3U2016 ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 940 NORTH ARM DR PIN : 07-117-23-11-0014 LEGAL DESC : PIRATES COVE : LOT O10 BLOCK 001 PERMIT TYPE : MECHANICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY VALUATION : $ 350.00 NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. NEW GAS LINE FOR MOBIL HOME CONNECT TO EXISTING PIPING TO METER APPLICANT MECHANICAL 50.00 STATE SURCHARGE MECH(VALUATION) 0.18 OLSHANSKY,ROMAN TOTAL 50.18 76 KINGSVIEW LANE N Payment(s) PLYMOUTH,MN 55447- CHECK 12607 50.18 OWNER OLSHANSKY,ROMAN 76 KINGSVIEW LANE N PLYMOUTH,MN 55447- 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 sepazate permits. All provisions of Iaws 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. n,„ � �(�% �_�� J�-3�- 1� �� `�....��-f� �0 ,3� �� Applic t Permitee Signature Date Issued By Signature Date � FOR CITY USE ONLY � � /�� O City of Orono (��p � � � �O P.O.F3ox 66 Date Received: `��Grermit# 2750 Kelley Parkway /Q� Crystal Bay,MN 55323 Approved By: � Amount$:�' U Phone(952)249-4600 Fax(952)249-4616 � � y � F � �qk�SHo�yF,�' CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits must be approved by the Building Ofticial 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 comp(eted. PERMITS ARE NOT VALID UNTIL YOU RECGIVE A PERMIT. WORK MUST NOT BEGIN UNTIL TNE 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. I-�ouse 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 ❑ Replace Job Site/Owner Information: Site Address: �'T(i �'l'�ZT� �1��t t�`"L��/r�- Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractar Information: Contractor: ��G[�`r�D tt�lkC1 ri�(,7 Contact Person: �f�(-Z� ✓l Address: ��,5 �1,-�'l�Jl. �i� State Bond #: �_� City: �l 'I�At Zip:`�� xpiration Date: Phone: �j�� -�r1%'? .� �77 Alternate Phone: L�l,t� �`��Z ��'l�'-7?7l� ❑ Insurance—Current: 1 ` � MECHANICAL SYSTEMS BEING INSTALLED 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: ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTILATION ❑ Na 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 Marshal[ijproposing 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: ��J�Zi�( ti`(�S i(,►�(� � 2 f li�l ti(,� Tt�' wt�'7'�'tL , - - C�,S � � o L�.s� �C�R- ��,��D� � �� PERMIT FEE CALCULATIONS 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) �C.i --+/� `y` � �� .�" X .��25 � �Vrw (contract price) (minimum�50.00) 2. STATE SURCHARGE �•. ��•` x.0005 $ ��j (contract price) 3. POSTAGE&HANDL[NG(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ `7� �� ■ * CONTRACT PRICE or JOB COST means the act�ial 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 accordanc '�h the es of the City and the reg�ilations of the State of Minnesota,and certifie that al st e ts ma e on this application are co�nplete,true and correct. ; Applicant's Signature: Date: �� 'Z`� �� 3 � �� DATE TIME CITY OF ONO CALLED IN � INSPECTION NOTICE SCHEDULED b PERMIT NO. �COMPLETED ADDRESS �'�! � V ' �� -- OWNER TELEPHON O.�� -x�� CONTRACTOR �� Q�� `' DESCRIPTION ` ��l% � �/� �/ W ❑ FOOTING ❑ DEMO-FINAL�f�-� ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING �Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL 2 ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL 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 �--❑-_ S�ErPTIC INSTALL Z OMfNERICONTRACTOR TO MEET�YES_NO � COMMENTS: � — /�, ,,..a r-.s�� o ! �,.�-,?�• - � � �' - o.�..., ,o � _ �,� �- � �i � � �J�r � k_��r-<<%'�- , W � Q � r r ` Z � h � �1 � � - � � �� - � � � , . � ., � � �r- , � 6'�:- , ` `-'a L c�S 6 J O A 41 IUS�I�SFAGIO�pOCEED PROJECT COMPLEfE � ❑CORRECT WORK 6 PROCEED ❑ UE CERTIFlCATE OF OCCUPANCY W 0 ❑CORRECT NlORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CONERINf3 PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDEH POSTED.CALL INSPECTOR ��TAT�O�ED�� , �� ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. �I N'` I � � l ��y Call forthe next inspection 24 hours in advanoe. (952) 249-4600 o,�c«,��«,$�L Inspector: �v YVhlte CoPYflnspector's FIN C�nary CoprlSfb Noties