HomeMy WebLinkAbout2003-P06853 - mechanical , � PERMIT
C�T �' �O F O RO N O Permit Number:
2750 Kelley Parkway- PO Box 66 P06853
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued: ioi3i2oo3
SITE ADDRESS: 3017 North Shore Dr
Wayzata,MN 55391
PID: 09-117-23-32-0002
DESCRIPTION:
Proposed Use: Residential
Pernut Class: General
Pemut Type: Mechanical Permits Permit Sub-type(s): Heating Systems
DETAILS:
Approved per resolurion#:
Separate pernrits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 66.19
Valuation: $ 5,295.00
State Surcharge Fee: $ 2.65
Misc.Fee: $ 1.50
TOTAL FEE: $ 70.34
APPLICANT' Sedgwick Heating&Air Condirioning Inc. OWNER: Judy Higgins
� 8910 Wentworth Avenue S 3017 North Shore Dr
Minneapolis,MN 55420 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Avnlicant, 1-Monthlv Revorts, 1-AssessinQ, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR MECHr��L��I.�IT
Box 66 (2750 Kelley Parkway) r�''
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�� �: Crystal Bay, MN 55323 � �
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° GENERAL INFORMATION F�
'1 ` ��
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 2 working days. �f�
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL ;�;f
YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON "��
THE JOB SITE. ;a a�
3. Mechanical Desi�ns - 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.
Duca shall be preseated cn form pro�•ided. Ideatification oi and speciizcations for water heatir_g equipment '';
shall also be 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. , �'-��
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6. All work must be inspected (rough-in and fmal). Call 249-4600. 24-hour notice required.
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7. House Heating Test Record must be submitted before final.
Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification.
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 249-4600. ���
Please check one: New Addition Repair ✓ Replace -� ''�� �,;`
� _�Residential Commercial * '�`'�
JOB SITE: .t Zip: „ r
Owner's Name: _ Telephone Number:����. t��� •�;,�t�� �'
Mailing Address. '�.� City�/ Zip: �S.�,Z� n:
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Contractor's Name: Tel° hone Nu ber: '`�'
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Mailing Address: City: Zip:
SYSTEM DESCRIPTION ,. ,�v,�; r �;
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HEATING SYSTEMS "
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Quantitv: , ! _ _ -
Make: � u.�.�cl
Model: _/��'
Fuel: c' '�
Flue Size: ��
Input BTUs: '. �� ,�:
Output BTUs: /;,�.,j�ll�l� h'
CFM: �'"'�
COOLING SYSTEMS
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QU1Iltlty. j� <"
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Make: �'
Model: � �`
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Tons:
- H. Power '
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� FIREPLACES �'"�� t� t � '
� � Gas factory fireplace �_ ���`�i 1 •� � ��'�,a
'� � Wood burning factory fireplace with flue �.��==�< '��-` � ;:'•� �"��`�;�w� `,� `
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Wood Stove � �
Wood stove with flue �"t ` �` x ;`: ��� �����.�erx
Brand Name Model No.
VENTILATION
No. Kitchen E�aust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. Other Fans: Locations cfm
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation Removal
Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PERMIT FEE CALCULATION
' 1. 1.25% of Contract Price* or Minimum Fee ($35.00)
��-�`�1�>5� y x .0125 $ �� ��
(contract price)
2. State Surchar�e. ** Add the State B ilding Code Division
.
- Surcharge to each permit. �75 x .0005 $ �.f�
or $.50, whichever is greater (contract price)
3. Postage and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ `7�..�� '
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted
work includin�materials, labor,profit, and other fixed costs. It is the amount to be charged to the customer
for the work done. If any maieriai, eqliipment, labor, or installation 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.
** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or $.50 - whichever is greater.
For valuations over $1,000,000 call the Department of Inspectional Services for the price.
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 Minnesota
State Building Code, and certifies that all statements made on this application are complete, true
and correct.
Applicant's Signatur'. Date: � Q,�
_ �
Approved By: Date:
✓
DATE TIME
CITY OF ORONO CALLED IN �Q`/�'113
INSPECTION NOTICE SCHEDULED jQ'�7 Q�
PERMIT NO.����� COMPLEfED
ADDRESS __ 3U17 ��Q�T� cS�dr� UJe.
OWNER � CONTR. .�'�u'�c �C ��'��
TELEPHONE N0. (So� ``��� rP��y�
� DESCRIPTION /
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMINCa �I:�MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24 � ER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD• 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE
W O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN
INSPECTOR W{LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the nex inspection 24 hours in advance. (g52) 249-4600
OwnedContr n i e:
Inspector. �
White Copyllnspector's File Canary CopylSNe Notice
SEDGWICK HEATING & AIR CONDITIONING CO. TEST RE'CORD �"�""�
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 • (952)881-9000
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ADDRESS � / CITY �"� � �
OCCUPANT � � • • OWNER ,
SOLD BY • � INSTALLED BY ✓����j°`U`
MAKE MODEL ����/ `7 �/ �/ ,,��
SERIAL NO. INPUT ,L,�-�
THERMOSTAT ���a J ��r
VENT SIZE
VALVE��� TYPE OF LINER �vL
La�►•-,� 3 `�
LIMIT � ��S�IV�n LINER SIZE
LIMITSETTING �` `� FILTERS: SIZE " �"��`wL /� NUMBER
FAN SETTING �`m �� WIRING '✓�'t�'j S(/r I�L
PILOT TYPE �/t li�r/L CITY OF ORONp TEST TAG �
IGNITION MODEL �L�'7V � LIGHTING INST. X
PILOT TIMING ����'�'� �� - �.-a 3
DATE TESTED
PRESSURE 3'5��� �'G pERCENT COZ � /
� COMPANY TESTING �y��L l�
INPUT CFH � 3� PERCENT 02
L // �
STACK TEMP. ��V PERCENT CO � NAME OF TESTER ' �v ��""�
FORM 235(REV.11/89) FORM DISTRIBUTION: WHITE COPY-JOB FILE YELLOW COPY-CITY