HomeMy WebLinkAbout2009-00083 - mechanical � CITY OF ORONO PERMIT NO.: 2009-000g3
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 03/i U2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 3200 NORTH SHORE DR
PIN : 08-117-23-41-0001
LEGAL DESC : UNPLATTED 08 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 2,232.00
NOTE: EXISTING HEATING SYSTEM-RELOCATE 2 SUPPLY AIR REGISTERS ON 2ND FLOOR
I BATH EXHAUST
2 OTHER FANS(AIR EXCHANGER)
APPLICANT MECHANICAL 50.00
STATEWIDE GAS SERVICES STATE SURCHARGE MECH(VALUATION) 1.12
201 WEST MAIN TOTAL 51.12
MN 55387-
(952)447-7185
OWNER
HENDRICKSON,RICK& SHIRLEY
3200 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 specifted 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 I 80 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
revoke at any time for due cause.
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Applicant Permitee Signature Date Is d By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESGRIBED ABOVE.
FOR CITY USE ONLY
�� `A� City of Orono z.. G
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/!¢ `Y '=:. P_O.Box 66 Date Received: �ecmit# o�j'J���-0� O�
��� � �'' 2750 Kelley Padcway `
�,`� ;`x� 1'���� Crystal Bay,MN 55323 Approved By: Amount S: ✓�. �
�:L�,���r�o�% (952)249-4600
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CITY OF ORONO—MECHANICAL PERMIT
(All Commercial petmits must be approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL INFORMATION
L You may apply for mechanical pennits 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. PERNIITS ARE NOT
VALID UNI'II.YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERNIIT CARD IS POSTED ON THE JOB STTE.
3. Mechanical Desisns—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 fonn 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. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
(Check All T'hat A 1 )
�Residential �Commercial(Approval Required)
❑New �Additional ❑Repairs ❑Replace
Job Site/Owner Information:
Site Address: �jz�l(_"1 /t��q.f-('� �h,�v�- /al/:
Owner: Mailing Address:
City: � f��v�.t� Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: S'�i��,.,i;c� ��,s ��vT:.z: Contact Person: � /v-v- /�'�-�—
Address: ,�/ L�• �r:,� S-t'. State Bond#: :�7���,;`�/
c
City: 1��rNw� /►�r✓ Zip:3�53� Expiration Date: �- d� 'L�7
Phone: JS�-Y��-�'�s Alternate Phone: 1��' �y�' 3`��3
� Insurance-Current: ..z3
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Note:All Geothermal Sysbems will now require a i Plan dt Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes �No
HEATII�iG SYSTEMS
Quantity: �d)�'�^c ��1S�-��►'�
Make: �- /l..+i i'� ,� — S�J l <'T /`-e�'.SPa!'l a.�
Model: .,� �� / �
F�1:
Flue Size:
Input BTUs: �
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity
Make:
Model:
Tons:
H.Power
FIREPLACFS
� Gas Factory Fireplace Brand Name:
Q Wood Buming Fin�place
� Wood Stove Model No.:
❑ Wood Stove With Fl�e
VEIVTII.ATION
Q No. Kitchen Exhaust duct recirculating cfm
� No. �_ Bath Exhaust(must have d�t outside) A _�cfm
� No. � Other Fans: Locations �R�_�i/'-t�/�r/' �x`�_cfm
FUEL STORAGE (Mast be approNed by Fin Mmsl�o&:j'�to a����pleca)
0 Installation 0 Removal
Fuel Oil: gallons ❑ Und�etground �Inside �Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Crrill � Other/List What dt Where:
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y , w��5�'�`3y,4�S."�.� cT �P'"" +t �` .�`� �h ys
� S ���F�•� .f�_ �t�`�d �c�,` n� :c.. $ ��}�+�� .P �� ���'.r3 �, `�e'%
�� `� s�`�t`i �� F.s."� ��,F p>� x�� �
'-: .,s,- :�,.(�, .U.. 'r� .t�.1as .�a:...��"s'i�a'i *k
0 Yes,this section applies
The replac�ent of a Residential fixtute or apaliance that meet4 all three of the following requirements:
1. Dces not require modification to electrical or gas�rvice.
2. Has a total cost of$500.00 or less;excl ' the cost of the fixture or applia�ce:and
3. Is improved,installed or replaced by the homeowner or licensed oo�ractor.
Skip ne�R section,if this applies; Cost of Permit $ I5.00
State Sutcharge $ .50
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
�
, ,.>.,a,���� ,,v��""� '�,.����; �r�F '��.t."`;
If above dces not appty;follow guidelines below:
1. CONTRACT PRICE •is 1.25%of contract price with a(Minimam Fee of$50.00)
x.0125 S
c��r�) c��aso.00>
2. STATE SURCHARGE •'Add the State Bldg Code Div.S�mchatge(1►�m�m Fce of 5.50)
x.0005 $
(contrac*P�rice) (minimum S .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S
• ' CONTRACT PRICE or JOB COST means tbe actual or estimated dollar amwmt chazged f�the
permitted work including materials,labor,profit,a�d other fixed costs. It is tbe amount to be chazged
to the customer for the work done. If any matcKial,equipment,labor�installations ate fumished by
the owner,tenant or any other party,the reasonable marke.t value of such items must be added to the
estimated cost or contract price f�peimit fee pucposes. 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 contrsct.
■ ••The STATE SURCHARGE is.0005 of the Building Department at(952)249-4600 for the price.
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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 State of
Minnesota, and certifies that all stabements made on this application are complete, true and
correct
Applicant's Signature: Date: vc^'v����
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