HomeMy WebLinkAbout2012-00431 - cooling system . CITY OF ORONO * 2 0 1 2 - 0 0 4 3 1 *
2750 KELLEY PARKWAY DATE ISSUED: 05/18/2012
• ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 1135 NORTH ARM DR
PIN : 07-117-23-14-0064
LEGAL DESC : SKARP&LINDQUISTS FERNHILL LA
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : COOLING SYSTEMS
VALUATION : $ 3,600.00
NOTE: 1 FUJITSU AC
APPLICANT MECHANICAL 50.00
CENTER POINT ENERGY MINNEGASCO STATE SURCHARGE MECH(VALUATION) 1.80
9320 EVERGREEN BLVD NW
SUITE B MAIL-IN FEE 2.00
COON RAPIDS,MN 55433 MISC FEE 0.00
(763)757-6202 TOTAL 53.80
OWNER
MEERKINS,C WEILER&R
1137 NORTH ARM DR
MOUND,MN 55364
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 sepazate
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 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 aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.�
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a , r/�(, l l C�7��'C.�-�f l l
Applicant Permitee Signature Date Issued By Si ature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER N DESCRIBED A VE.
FOR CITY USE O�iLY
� �' � ��� City of Orono
Jif 4��\``t p.0.Box 66 Date Received: Permit#
t'��;;;,.,� ���` 27�0 Kelley Pazl.�vay
�a '� t -, �1i Cry•stal Bav,MN S�i23 Approved By: Amount$:
s �'r a f
���o�vaf`��' Phone(952)249-4600 Fax(9�2)349-4616
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��Q CITY OF ORONO—MECHANICAL PERMIT
�1. ( (All Commercial permits must be approved by the Buildine Official or Inspector and/or Fire;�4arshall)
K/
GENER.AL 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 retum mail after a review is completed. PERMITS ARE NOT
VALID LJNTIL YOli RECEIVE A PERti1IT. WORK NIUST NOT BEGIN U'�'TIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desi�ns—Complete calculations,details and specifications are required ior each
heating,ventilation,humidification-dehumidification,and air conditioning installation including
heat loss,�heat eain 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 remodelin�is involved,a separate building permit must be
obtained.
�. All w�ork must be done in accordance with the Uniform I��lechanical Code/State Building Code
requirements.
6. All work must be inspected(rouoh-in and final). Call(952)249-4600.
(24-48 honr notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
(Check All That A lv)
�Residential ❑ Commerciai(Approval Required)
i
❑New ❑ Additional ❑ Repairs ❑ Replace
Job Site/Owner Iniorm.ation:
Site Address: �`3� �at'`!-V� �rY�'� ��V+�,
Owner: ��J W�� `L(� ?vlailinQ Address: � �35 No�`�^ Arn'��Q.
city: O('C�Y�[� zip: `SS 3lo�f
Home Phone:���'' �1�� 3��� Alternate Phone:
Contractor Information:
CENTcRPOINT ENERGY JOANN ZINKEN
Contractor: Contact Person:
9320 EVERGREEN BL STE B 2201 3346
Address: State Bond#:
City: COON RAPIDS Zip.55433 Expiration Date: OHI2O/� 2
Phone: �763� 7H5-54O4 Alternate Phone:
Travelers indemnity Company
Workers Compensation&Employers Liability
� Insurance—Current: Policy#TC2K-UB_93496101
1 Policy Period O1/Ol/2012-01/01/2013
MECHANICAL SYSTEMS BE1NG INSTALLED
Note: All Geothermal Systems will now require a Site Plan&Review by our Buildinj Official.
IS THIS GEOTHERI�LAL? ❑ Yes �No
FIEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CF V1:
COOLING SYSTEMS
Quantity: �
Make: ti+.. . ��t►l
Model: �bll� l s (��.5
Tons: , �I t�
H.Power
FI�tEPLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove ?vlodel No.:
❑ Wood Stove with Flue/I�fasonry
`'ENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
� No. Bath Exhaust(must have duct outside) cfm
No. Other Fans: Locations cfm
FUEL STOR�GE (�Ylust be approved by Fire Marshall ijproposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: �allons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
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PERMIT FEE CALCULATIOIti'�S)
BASED OFF - 2002 STATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture or appiiance that meets all three of the followin�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,installzd or repiaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cos:of Permit � 1�.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
PERI�IIT FEE CALCULATION(S)—JOBS OVER$500.00
If above does not apply;follow�uidelines below:
1. CONTR4CT PRICE * is 1?�°�0 of contract price with a(Minimum Fee of$�Q.00)
3c.00 . ao X.oi2s � 60 .00
(contract pncej (minimum 550.00)
2. STATE StiRCHARGE
3ls 0� • G O x.0005 $ � .�O
(contrac:price)
3. POSTAGE&HANDLI?�1G(Cnly on!�Iail-In Applications) $ 2.00
4. TOTAL PERNIIT FEE(Add Lines 1-� Above) $ 5.'3�g�
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount char�ed for the
permitted work includina materials, labor,profit, and other fixed costs. It is the amount to be charged
to the customer fer the work done. If any material, equipment, labor or instaliations are furnished by
the owner, tenant or any other party, the reasonab?e 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 reGuest the submission of a si�ned copy of the actual contract.
MECHANICAL PERMIT APPLICATION AGREEMENT'
The undersigned hereby applies to the City for issuance of a Mechanical Permit, a�ees 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: 5�/S�/L
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