HomeMy WebLinkAbout2016-01499 - mechanical , = CITY OF ORONO * 2 0 1 6 - 0 1 4 9 9 *
2750 KELLEY PARKWAY DATE ISSUED: 1 U30/2016
ORONO,MN 55356-
(952)249-4600 FAX: 952) 249-4616
ADDRESS : 3120 NORTH SHORE DR
PIN : 09-117-23-32-0007
LEGAL DESC : CRYSTAL BAY PARK
: LOT 000 BLOCK 002
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 6,900.00
NOTE: ALL TESTMG REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
TRINITY GAS BOILER
APPLICANT MECHANICAL 86.25
STATE SURCHARGE MECH(VALUATION) 3.45
OWENS COMPANIES,INC. IVIpIL-IN FEE 2.00
930 EAST 80TH STREET
BLOOMINGTON,MN 55420- TOTAL 91.70
(952)854-3800 Payment(s)
Minnesota State License#:mech-Mb003718 CREDIT CARD 7497 91.70
OWNER
BORN,RICHARD
3120 NORTH SHORE DR
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMEIYT
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 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 suthorized 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.
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Applicant Permitee Signature � Date Issued By S' ature Date
Nov. 30. 2016 2:08PM No. 4600 P, 3
, , ,
OR US�O1V[.'Y
City of Orono tt /�
/� P,O.Box 6G Date Recei . �/'� permit# ` �
��V 2750 Keliey Pazkway /
Crystal Bay,MN 55323 ApproVed By: An�Oun[$:�
Phone(952)249-4600 Fax(952)?49-4616
� ��
�jqk�'SHOa`�G CYT'Y OF O�.i0N0—MEC�TANICAL PERMIT
(All Commorciai permils must be appmved by�hc nuilding Official or]nspecror and/or Fire MsrshaA)
GENERAL TNFORMATYON'
1. You may apply for mechanical permits by msil or in pezson at the City o�'ices. Applicarions vvill
be rer+ieWed and a pcamit wilI be issued within two workiitig days.
2. Pcrmit cards will be sent by return mail after a revie�uv is complctcd, PERMITS A,R�NOT
VAY.YD UNTTC.,�'OC1 K�CEIVE A PERMIT. WORK M1US'�NOT B�GIN YJN'I'Y�,T�C�
PERMIT CARD IS�OS'X`��ON'rY��,�0�SYT�+.
3. Mechanical pesi¢ns—Compleie calculations,derails and spocifications are required for each
heating,ventilation,humidification-dehumidification,and air conditioning installation including
heat loss/htat gain calculation,desigm,tem,perapu�es,equipment ratings and identification as to
type,manufacturer and model. bata shall be presontcd on form provided.
4. When an�+new construction or ranodeling is invol�ed,a separate building permit must be
obtained.
5. All work must be done in aecordanee with the Unifonn Mechanical Code/State Huilding Code
requirements.
6. AII work must be inspected(rough-in and final). Call(952)249-4600.
(z4�8 hour notice required)
7. House Heating Tcst Rccord must be submitted before final.
T'Y�E 0�pEltlViTT
Check All That A 1
]'�Residential ❑Commereia((Appro�val Required) [Backflow l�evice:�A'VB ❑P'V'�]
❑New ❑Addi�ional ❑Rcpairs �eplace
Job Site/Owz�er rnformation:
Site Address: � l'�D ���RT N 5`N 6�E ,�( k �U �
Owcaex:��C�14 217 (�j 0 � Mailing.A,ddress: �/�U 12TN-��1�� ���V�
City: D IQO�IO Z;p� � �� �
Home Phane� ��o� ' ��P�'�0��� Alterna�e Phone-
Contractor Ir�formation.:
Contractor: nS �n i�S 1 QC � Con,tact person: �r�n h e �o it�b n
Addz'ess: �U ��ZSt �*StflCt State Boz�d#: � �� ��� �
City: ( dh��n Zip: ,�5�{o`t� Expuation Date: � I� °,��g
phone: Sa" �D�'s�d� Altemate Phone:
❑ Insurance—Current: ��S
1
Nov, 30. 2016 2: 08PM No, 4600 P. 4
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- �:�;�..�:�:�,....;M:; ..;;;� . .,. ..,� •'�,:.:,
i?+�'�ff�.''j�a•: '..4,��...�'�^:3+� �,'�.1�^l, �is'.�:1�1:tV��•11^F�7:l,Ld31::d�L•:'1�`r::�::,
Note:All Geothermal Systtms will now require a Sitc�lan Bt RevieW by our Building O�icial.
Y,S�'�IS CEOTX�RMAY,? []Yes '�No
�ATING S'Y'ST�MS �75�Jp��u'�
Quantiry:
M��: 1�"T l
Model: TR.1 I�l I 5�
Fuel: �9�
Flue Size: °�`
Input�TUs: �1�,�,S�
Out�ut BTus: ��H' I`!I — .
c�:
COQLIN'Cr S'SISTEMS
Quan�it�:
Make:
Model:
Tons: •
H.Power
FIR�p�,ACES
❑ Gas Factory Fireplace Brand Name:
�❑ V�/ood�uming�'ireplace
Wood Stove Modcl No.:
❑ 'Woad Stove with Plue/Masomy
'VENTILATYON
❑ No. Kitchen Bxhaust duct recirculating efm
❑ No. Bach F�xhaust(must havc duct outside) �
❑ No. Other Fans: Locations ��
FUEL STORAGE (14�ust be approved 1iy 14"ire A�arshnll'rf propoar.ng to pbpndoa tank�n plac�)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outsidt
r,p G,�: gallons
Other:
GAS�.�ONLY
❑ Outdoor Grill [] Other/List What&Where:
2
Nov, 30. 2416 2: 08PM No, 4600 P. 5
:�;��r;:�:' :���'° ��'�T���:����0�� �
1. CONTRACT PRCC� *is t.Z5%of contract price wit�►a(Minimutn Fee of 550.00)
`��oic10l�r04 x.0125�
(crn►trsct price) (minimum s5o.o�
2. STATE STJKCY�AY�G�
x.0005 $
(conzrac�price)
3. POSTAGE dC HANDLIlVG(Only on Meul-Irt AppliCation8) $ 2 0�
4. TO'�A�.p��tivX�'�k'EE(Add Lincs 1-3 Above) $
■ • COI�ITItACT PRICE or JOB COST means the actual or esrimated doller amount chargcd for the
permitCed work including materials, labor,profit,and other fixed costs. It is the amount to be charged
to the customer for the work done. Tf any materisl,equipment,labor or installations are furnishcd by the
ovvner, tcnant or any other Puty, the reasonablc market value of such items must be added to the
cstima�td cost or contract price for permit f�purposes. In the evoat thst thcre is a dispu�e oa the amount
of the job cost, the Ciry ma� requesr the submission of a signed copy of the actual eontracc.
� 1�3 - �} /-�;y�� — 'r h-/����.7��� :y.•...:,_� ,c...:,,,.
���:R^h�lY'l�lu.' :Fei�' �, :��.FT.r1 ,1�D` "�k�!. . .�:."
j5 :�',f'
The undersigned hereby applits to the City for issuanee of a Mechanical Permit,agrees to do all
work in strict accordance with the ozdinartces of the City and the regulations of the State of
Minnesota,and certif'ies that all statements made on this application are completc,truo and conrect.
Applicant's Signature: f � Date: �/I3d/�0��O
3
Nov, 30. 2016 2:08PM No, 4b00 P. 6
� ,
T�rinity T�ti154 Submittial Sheet
Section 1-Specitications
gigh �fficiency Gas-Fired ScC[ion 2-D'unansions
1�rcsra,ram�.
Condensing BoiY�x Scction 3-Electrical
Date:
Project Name:
Locadon:
Engineex:
Contractor: �ep�
��SPECIFICATIOWS
General Specificatio�ns
►r•a�tory suppu�a 1��
►Y'roduct Features . !Ok Outdoor scnsor(System scnsor optional)
. Ccrbfied to ANSI Z21•13/CSA a.9 Gas-fired Boiler Standard � 3oPST ASME Pressurc Relief Vulve
• ASM�"I�"stamp�boiler,designed and construc�ed in compliance � pressure/Tcmpecaturo Gaugc
with tho p,SNIE Boi[cr and Press�re'Vcssel Code Scetion 1V ��n�rol k'eatures
. gq24¢543932 Stauilees 5tce1 fCeat Txchanger . �tegral mieroproeessor sefery contml
. Maximum operating presswe 30 psi • z centrsl heat inputs(high 8c IoW temporature)
. Fitld convcrsion from Natura]Oes(factoc�)to Propaue . Domescic�Tol Water Priority
• Modula[ing bumer, 10:1 tumdOwn . Outdoor roset
. bircc�Spark Ig�idon • Rrarm woather shutdown
. Wall(s�anderd)or floor mounting(w/opt,lcit,NTl part#84b30} � �'� u Co S Tft serios boilers
. Zero clesrsncc to combusiiblcs(cicarnnces rcquircd for service) g P
►Optional Side Wal►Vent Terminal YC.it(NTI Part#85062,84357&82666) • Tntegra�ed Modbus R1''U for conncction to�MS gateways
Vent/Air-Inlet VenbAit-finlet Approx.Vi�ei$ht wdth Water
Water Connechons Gas Gonnec�on �,
NPT;1n. N'PT iu. Plpe DismeteX,ln. Mai.Length,ft,
� g 150 180
1(Male) 'h(Ivlale)
Performaace Spec��icatxons
DOE�eatu�g Capacity,lVIBH Nct Y=�R Ytating,lV1BS ,AFCI�,°/.
lnput Maaulatiou,lv�� 9�
15.4-154
141 1�
s
4
�
�
� z
0 6 a �o �z �a 16 18 u
2 4
FIOW(US(3PM)
AS
��� � • � ME
� s N
C . US
NX Thermal Inc.
30 Stoncgste Ur.,Saint lohn,l�B E2FT OA4 Canada W����builers.cu�
Techoical��rv�cc„781�'688;.v��he�ighr ro chung'e Ihere sp�u+rthuu wrlli�noeice
201 G-06-09 Rev.O
Nov. 30. 2416 2:08PM No, 4600 P, 7
Trinity Tftl�54 Submittal Sheet
Hig� Efficiency Gas-�ired
,��,,,,,,,,�. Condensing Soiler
`2� DIMENSIONS
•i
Product Dimenszona—in.
UNE VOL7IVGE (,pyy yp�TpGE
�r�794—~� CO NFCTI NSQ C�OPINEO ONS
000 0•
Q •. .
24 4 19� � •
1
� �
s
TO P B OYTO M
� ��� '�
�
�
33� 4�
■
� �� � 1� � �
FRONT �� �� '
13� �
RIGHT �
Recommended Clearances—in. (�mI
•Front Top 5ldes Bacl� �otDom �ue Pipe
36[914] 24[6l0] 12(305] 0 24[610] 1 [25]
s�p �- � AS
� � M� �
C US o M
N'Y'Thcrmal Inc.
30 3toncgatc Dr.,5aint John,NB E2H OA4 Canada
Technical Serrice:1-800-68B-2575 Fax: 1-506-432-1135,'W'eb:http://www nlib ' om
2016-06�09 Ttev,O NYTher»�u!lnc.��esarvas rhe rigl+r eo change�heae sp�ificalfonx wilhoNr xotice
Nov. 30. 2016 2:09PM No. 4600 P. 8
� , ,
Trinity Tft154 Submittal Sheet
�i.g� Ef�iCYency Gas-Fired
1Nz,,�,,,,,�. Condensing Boilex
v�� ELECTRICAL
Simpli�ed'VV'iring Diagrams
Liae Voltage�lectrlcal: �2ovac suPr�r PUMP A PUMP B PUMP C
� 120VAC/60�-T2/1 Phase/12 Amp
► �arria S(rip for field wiring tetminations
► 3 Pump outputs
• lndirect Domestic Hot Watcr(Pump A,)
• BO1�CI�PUIL1�7 B� SERVICE SWI7CH
(FIELD 5UPPLIED) J
� CBYItr�I�CAt�pU�p C� a5 O
> j
J w
Note:Pumps are field�upplied. � �
i �,� o �
_ .o�/ ,
" o
3 ra�
� O
� ��0 0
6 .y 0 ,
6 � OO
O
� �eiA�,
��� O
e y' �
! 1 �
- - �.ow'V'oltage�lectrical: '
► Barrizr Strip for fieId wiring terminations
�� ► 120/24 VAC Transformer 40VA(facrory supplicd)
► Inputs
�� • CHl thcrmnstat(by others)
�� • CH2 thermostat(by others)
a �'� • Tndirect DHW aquastat(by others)ox D�'VV Tank
�H�� � sensor(factory opiioln)
�� �'�' �"" _ • �xternal Limit(by others)
'� - Ouidoor sensor(factory supplied)
• System sensor(factory option)
�� • 4-20mA external modulating control(by others)
"" ► Outputs
�r � . Alarm dry contact(24VAC 0.63A ma�.)
�� ��cw� � ► ETA-485 Modbus communications�or�.ead-Y,ag
• ► E�A-485 Modbus to BMS gateways(not shown).Optional
available gateways:
•; . BACnet/N2-N'I'I part#84946
• C.onWorks-NTT part#84947
A
��° � � SME
C US � • p �
NY Thermal Inc.
30 Swnegate br_,Saint John,ND E2fI Oa4 Canada
Teehnieal Serviee: I-800•688-2575 Pax: I-506�32-1135 Web:htcp://wy!w,nabuilcrs.com
2016-06�09 TLev.O NYThei niallnc.raserves Ihe rlgh!►o Ghpnge►hese speC�Ccl�ions wi�haul nolice
11/30/2016 15:37 FAX 7635925700 MTI �001/002
, , •
D I s T R � a u T � N G Facsimile Transmittal
I7ate: No�vember 30,2016
Namer Accounts Payabl�
Company: Orono GC 40Q'129
952.249.4616
Fax Number:
Nitmber of Pages Includdng Cover: 2
T7ear Valued Cus�omer;
Thank you for your commitment to MTI and your interest in our products. We gre$tly appreciate having you as our customer!
Attachad you will find an Aceount lnformation Update form. 'T'he updated account informaiioe wi11 assure rhat MTl has current
information to ansure iimely inieractions for both your organization and MTI.
Please take a momem io fill out and sign the a�tached Account lnformation Update form and return at your earliest convenience.
Please,also,take a few rnoments to confirm you have the correct address for mailing payments.
MTI DistribuCing Inc
SDS 12-1900
PO Box 86
Mpls,MN 55486-1900
We also accep�payments via ACH/wire transfer,if interested,please eontaec us for bank/remit informadou,
In an effor�to go pap�rtess,may we emait your invoices and monr.hly stazaments? If so,please provide the email address(es)—up�o
2,where you would like these seni,
Please feel free to contact me if you have eny quzstions.
We appreciate your prompt anention to ihis maner.
Regards,
7'en'G Kn,u.tb�v� C�,4
Assistant Finance Manager
�
Dlrect Phone(783)592-5646,Fax(763)592-6646
E-mail;Teri Knutson�mtidistributina.com
Mr!Distributing,Ina
4630 Azelia Ave N„Brooklyn Center,MN 55r129
7Q�1Y00
11/30/2016 15:37 FAX 763�925700 MTI �j002/002
� ACCOUNT INFORMATION UPDATE PHotvE: 763.592.5600
F,4x: 763.592.5700
(For Schools,Municipalities,COb,�tc...� TOLL FREE: 800,362.3685
Fwc 800,36Z.5444
o i s T R i e u T i N � 4830 AZELIA AVENUE NORTH,SUITE 100
BROOKLYN CEN7�R, MN 55429-3831
Business Name:
Billing Address: Business Phone: ( )
CitylState: Zip: Fax Number: ( i
Shipping Address: Phone: ( )
Citp/Stat�: Zip: County:
How long established: Numbar of employee6: Type of business:
Sales Tax Status: Taxable Ex�mpt Tdx Exempt Number Tax Examnt Cartificate Reouired
Legal enqty: Corpof�tion Partnership Proprietorshlp Qther
Fedaral ID numbar: Your MTI Sales Representative
What produc[(s)will y0u be buying? TORO: Irrigation Parts Commarelai
OTHER:
WOuld you like documenls fsxed,mailed,are•malled to you? (Pleabe GfYCI��il preference for each) Statemenffi7 Fax Mall E-mail
(nvoice57 Fax Mail E•mail
FaX to: ( ) E-Mall Addross:
Do you require a Purchase Order7 Yes No
Purchasing contact: Title Phone
If wa havA a questlpn regdl'ding your aCCOunt,who should we contact?
Name Tltle Phone
MTI Distributing Inc.is authorized to Investlgste applicant's credit records and verliy the information given above.
In consideratlon of uedlt extended to me, or members of my flrm, I (1Ne} dgr+9e to pdy my (ou� account in full axording to tertns specified on the
inv�ice(s),and all handling/restocking charges. I (yVe)further agree to pay a service charge of 1-5%per month(18%annum or suGh oth�r maximum
rate permitted by law}assessed on any past due portion of my(our)account. I(We)fuRhe�understand and agree that ir1 the 9vent my(our)account
become6 dellnquent, I (We)wilf be responsible for payment o}CollectiOn costs and reasona6le attorney's fees incurred by you ff outside efforts are
necessary to collect my(our)axount bafance. I(We)expressly agree as a paR of this Credit Application that I(We)will notify MTI Ois�ributing,Inc.In
writing of any change in the ownership or mdflagement of the applicant company,ancl/0�Chdnqe in the legal identity of thB Cpmpany, and/or termination
of the buslness and suCCession to the business operations by any other pe�6on o�legal entity. MTI Dlstrlbuting, Inc, reserves the right to revoKe Credit
to the Applicant at M71 Di9tributing, Inc.'s sole discretlon�nd without notice.
Date Signature
Title
� ' op..�oon. mtidistrlbuting.com
,Nfll is ctn Equu!nppor•rr�rilty'/Affi►�m�ul4���rt�,M r;m�rcr;-Nr
Nov, 30, 2016 2:08PM No. 4600 P. 1
FAX TRANSMITTAL COVER SHEET
pWENS COMPANIES, INC.
930 East SOth Street
Bloomington, Minnesota 55420
Telephone: (952) 854-3600
Fax: (952) 854-3769
TO: Permits DATE: 11/30/2016
COMPANY: Ci of Orono FAX N�: 95Z-249-46'16
FRQM: Corinne Condvn
SUBJEC7: Mechani�al Permit-Boiler
NUMBER OF PAGES INCLUDING CQVER SHEET : '
MESSAGE:
Please find attached Mechanical Permit Application--3120 Northshore Drive, Orono.
Submitted a Mechanical Permit on 11/28 for gas furnace, this is for a gas boiler.
If you have any further questions, please do not hesitate to contact me af
ccondonCc�owensco.com or 852-703-5702.
IF Y4U DO NOT RECEIVE ALL PAGES IN LEGIBLE FORM,
PLEASE CALL(952) 854-3800 AS SOON AS PQSSIBLE.