HomeMy WebLinkAbout2016-00347 - mechanical , CITY OF ORONO * 2 0 1 6 - 0 0 3 4 7 *
2750 KELLEY PARKWAY DATE ISSUED: 04/07/2016
ti ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 2545 NORTH SHORE DR
PIN : 09-117-23-41-0003
LEGAL DESC : LTNPLATTED 09 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 3,000.00
NOTE: REPLACE HEATING SYSTEM(BRYANT HRV)
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.50
BLUE OX HEATING&AIR MAIL-IN FEE 2.00
5720 INTERNATIONAL PKWY
NEW HOPE,MN 55428- TOTAL 53.50
(612)238-9709 Payment(s)
Minnesota State License#:mech-MB671957 CREDIT CARD 0100 53.50
OWNER
BERGQUIST,CARL&ABBY
2545 NORTH SHORE 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 goveming 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 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 l/1
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Applicant Permitee Signature Date Issued By Signa Date
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' �TOR Cl'R'Y USE ONLY
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2750 Kellcy Parkwny
Crystal say,MN 553z3 ,Apprpved By; Ameunt S:
, Phonc(952)249-46U0 Fax(952)249-4616
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�t'�k�sNo��'� CITY OF O�20N0—�V�ECAANICAL PERMIT
(All Commercial permi�s must bc approved by thc Building Offic�al or Inanector end/or Fir�M�rshall)
j �I�r�E�TE�tA.G XNFORMATION '
1
' 1_ You may apply for mechanical permics by mail or in person at the Ciry offices. Applications will
, be reviewed and a permit will bc issucd within two working days.
2. Permit cards will be sent by return mail after a rev�ew is completed. PERMITS ARE NOT
VAL1D UNT1L YOU 12�CE1'VL A PERMIT. WOAK MtIST NOT BEGiN UNT1L THE
PERMIT CARD iS POSTED ON THE JOB S1TE.
3. Mechanical Desiens—Complete catculations,dctails and speeifieations ace required for each
heating,ventilation,humidifieation-dehumidification,and air condit�onin�installaaon ineluding
heat]oss/hcat gain calculation,dcsign temperatures,equipment ratings and identi�cation as to
type,rx�ar�ufacturer and model_ Data shall be prescntcd on form provided.
; 4. When any new construction or remodelins is iovolved,a separate building permit must be
, obtained.
5. All work must be done in accordance with the Unifarm Mcehenieal Code/State Building Code
rtquirements. ' �
, 6. All work must be inspeeted(rough�in and final). Call(952)249-4600.
' (2A-a8 hour notice required)
7. House Heating Test Record must be submitted before fina1.
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�Residential ❑Commercial(Approval Required)
❑New ❑Additional ❑Repairs �■ Replace
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h�;q,, ,Ite/QWlrueir'�nfo,li�,at�,o�;i�i�,+,l�,�ier,<<ilitii�lll�ll�l1��l�d;';+�,';
s;�Aadress: 2545 Northshore Dr
Abby & Carl Bergquist "
� Owner: Mailing Address:
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City; Zlp:
Home Phone: 952-994-����� Alternate Phone: �
�nr,u���a,�� i`y�r��b�7lf�l��t'1 � r,�,
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�t"P���I����������i rS���� �s�,1� �� ii� d �
Contractor: Blue Ox Heating&Air Contact Pe�son; Jennie Wood �
Address: 5720 Intemationai Pkwy Stat�Bond#: M 8�7�957
' New Hope MN 2017 �
City: Zip: Expiration Date: ;
6��-�3$-s7o� ��
Phone: Alternate Phone:
� 0 Insuzat�ce—Current:
Owner's Insurance
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� Note:A11 Geothermal Systems will now require a Site Plan&Revicw by our Building O�cia1.
' �S�'HTS GEQTHERMAL? ❑Yes �❑No
� �-�--��.-�
� I�EA'�NG SXST �
Qusnlity, 1
Malce: Bry�rit H RV
WRVXXLVU1330
; Model:
i Fuel:
'� Flue Size:
� Input BTUs:
� Output BTUs:
�
CFM:
• COOLiNG SYSTEMS
� Quantiry:
Make:
Model:
Tons:
H.Power
�IRF.PLAC'ES
❑ Gas Factory Firep�ace Brand Name:
❑ Wood Buming Fireplace �
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Iv�asonry
V�NTILA'1'ION
❑ No. Kitehen Bxhaust duct recirculating cfm
❑ No. Buh Exhaust(must have duct outside) cfm
❑ No. Other Fans: �.ocations cfn,
FUEL SfORAC� (Must be apprpved hy Fire Marshall if proposing W pbandon tank[n place.)
❑ lnstalladon ❑ Removal
Fuel 0ii: gallons ❑ Underground ❑�.nside [I Ou�side
LP Gas: ga�loaas
� Other:
GAS LINE ONLY
� Outdoor Grill ❑ Othcr/List What&Wh�re: _
2
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i ❑ Yes,this scction applies
I Thc rcpiacement of a Residential fixture or_a�aliaar,g that meets all three of thc following requiremenu:
1. Does not roquire modification to electrical or gas serviee.
I 2. Has a total eost of$500.00 or less;exclud�ina the cost of the fixture or applianee:and
i 3. is improved,installcd or replaced by the homeowner or licensed conbractor.
Skip next section,ifthis applies; Gost af Pcrmit S 15.00
State Surcharge $ 5.00
Mail-ln Fee(If ApplicAble) S 2A�
'�otal�ermit Fee S
If above does not apply;follow guidelines below;
1. CONTRACT PRTCR *is�.25°h of contract pricc with a(Minimum Fee of$50�00)
3000 x 01�5$ 50min ,
. (Contraetpricc) (minimum S50.00)
2. STATE SURCHARG�
3000 x.000s s�.5
c�o����� �
3_ POSTAGE&HANDLING(Only on Mail-In Applications) $ � �
�}, 'J�
4. TOTA,�P��T k'�+E(Add Lines I-3 Abovc) $5�' � J
■ • COIV'TRACT PRICE or)OB COSr meens the actual or esti�r►ated dollar amount chsrged for the
permitted work includin�materials,labor,pro�it,and other fixed eosts. It is the smount to be chargcd •
to�he castomer for the work done. If an�y nna#erial,equipment,labor or installations are fumished by
the owner,tcnant or any other party,the reasonable market value of such items must b�added to the
estim�ted cost or contract price for permit fec purposes. In the event that there is a dispute on the
amount of the job cost,the City may request the submission of a signr.ef eopy of the aetual co�tract.
The undersigned hereby applies to the City for issuanCe of a Mechanical Permit, agrees to do all �
work in strict accordanee with the ordinanees of the City and the regulations of the State of }
Minnesota, and certifies that all staicmcnts made on tl�is application aze completc, true and �
correct. I
. A,pplicant's Signature: Date: 4/�/1�
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