HomeMy WebLinkAbout2016-00409 - mechanical � _ CITY OF ORONO * 2 P1 1 6 - 0 0 4 0 9 *
2750 KELLEY PARKWAY DATE ISSUED: 04/22/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 3925 NORTH SHORE DR
PIN : 17-117-23-22-0007
LEGAL DESC : LJNPLATTED 17 I 17 23
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 7,300.00
NOTE: (1) LENNOX FURNACE AND A/C
APPLICANT MECHANICAL 91.25
STATE SURCHARGE MECH(VALUATION) 3.65
GOLDEN VALLEY HEATING&AIR MAIL-IN FEE 2..00
5182 WEST BROADWAY
CRYSTAL,MN 55429- TOTAL 96.90
(612)535-2000 Payment(s)
CREDIT CARD 7420 96.90
OWNER
CHRISTINE,LYNN
3925 NORTH SHORE DR
MOLJND,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 does
not grant permission for additional or related work which requires separate
permits. All provisions of laws 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 authorized is not
commenced within l80 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.
a��L ��l `f i��/�o
Applicant Permitee Signature Date Issued y ignature Date
04/21/2016 15:46 7635354379 GOLDEN VALLEY HTG PAGE 01/04
. �.
FOR CITY USE pN�Y
�O A rQ City of Qxono
i v P-O.Box 66 Aate Received: Penn�t#
2750 K.elley Patkway
Crystal8sy,MN 55323 Approved By: Amount$:
P4one('93z)7.49�600 Fax(952)249-46�6
y��,r��Har.'c�'� CITY pF ORONO—MEC�,ANxC,A.L PERMT�'
{All Commercial pe�iooars must be approved by the Buildiag O�cial or Inapeceor and/oe Firc Mazshalf>
�ErrE�,nvFox��zoN
1. 'XCu�pp�ay apply foX:nuechanical penaaiits by mail or in pexso�at t�e City offices. A,pplicat�oms wiII
be zeviewed end a pe�it�will be issued withiu two worlcing d&ys.
2• �eznnit catds will be sen,t by;retum mail a#ter a xeview is com�Ieted. Q��TS ARE NO'�'
VALID UNT1L YOU�tECEIVE A PE�'T. WORK 1VIUST NOT SEGIlV UNTIL THE
PE i5 POS N T�E d B S
3_ �ech�nical Desi�as—Complete calcuaatio�as,dvtails and speci�'icatioms axc rcc�uircd for each
hcatin�g,v�ntilatioa,�ubeidification-deb�w7uidi;&cat;on,and air co�ad�itioni�ng installatiom i.acludiz7,g
h�t losslh�eat gain caiculation,design tempc�atures,eqwi�ueint ratsngs and iden��,�ication as to
cy�e,manufacturcr as�d aat,od,ol. Data shall be pzese�orted on form provided.
4. 'Wben any ncw conshuct�on or remadoling is involved,�sep�rate building pexzbuit tx►ust be
obtained.
5. All wrnrk musc be done in accordance.with�e Uniform Mechanical Code/Srdte Building Code
rcquaeamez�ss.
6. A11 u+c��C must be inspected(rough-in and flnal). Call(9S2)Z49-4600.
(2448�a�r no�ce re�aired)
7. House I�eating Test�ecoz�d must be subrnitted before fina1.
TYPE QF�'BRMCT
C�aeck A11 Tb,at A 1
,�Resadential ❑Coz�a,mercial(Apprpvai J,�equired)
❑New ❑Additienal � ❑Repairs �eplace
Job S,ite/Owrier Infor�uat�o�:
Site Address; � �� �f71"'� �� � 1��
Y!Yl ' �Ct,rY►_Q
owner:� L . �/��'�� Ma�ili�ag Aadress: .�
Ciry: — ---- Zip:
Ho�oc�e Phone: ��'",�h ' �'�� ��� A,l,ternate Phone:
Contractor�'o�nma#ion:
Contractor: G • �, Contact Persont:
5f�2 WEST BROAdwAY
Address: ,��� State Bo�,d#:
City: Zip: Ex�i.rahon Date:
Phone: ,Alte�nn,ate Phone:
❑ T�o�surance—Current:
1
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�1Tote:Ail Geothernaa�.Systems wiil now requiure a Site Plan&Review hy our Bwildiu�g Offtcial.
IS Tffi3 GEOTHERMAL? ❑Yes �No
HEATING SXS�'EN�S
Qu�ary: 1
raake: n
�oaez: (..,f�U�(�i.l�7C�3{,�PI
k'ue1:
�'lue Sizc:
Tnput BTUa: ��� __
Output BTtJs: ,�Q G
C�M:
COOLYN(�SXSTEIVIS
Q�riri: 3
Mzke: �iYlf�,a,� ---- -
Model: � `7 /'���
�'ons: � r�
H.Prnver
�7REPLAC�S
❑ G�s Factory Fireplace Brand Name:
❑ Wood Burniuo,g�ueplace
❑ Wood Stove MadellVo.:
❑ Woad Stove w�it,�Flue/Masonry
VEN
❑ No. ICitctze�,Eashaust duct recirculat��ng cfm
❑ No. Bat�t Exhaust{must have duct outside) �{m
❑ No. Othcr Fans: �.oca�ions ��
FUEL STORAGE (Must be qpproved by 1Cite ll�arshQll ifproposing to aBandOn tank in,plac�)
❑ Instal2atiou ❑ Rcmoval
]Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Otb�er:
GAS L�NE ONLY
❑ Outdoor Crr�'U ❑ Other/List VJhat&"Wb�ere:
2
04/21/2016 15:46 7635354379 GOLDEN VALLEY HTG PAGE 03/04
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❑ Yes,this section.applies
The replacement of a Residential fixture or aRpliance that no,etts all three of the following requi�temtnts:
I. Does not�uiu�e modifica.tion to elect�nical or gas service_
2. Has a mtal cost of$500.00 or less;c c u ' the cost of the fixture or applxaz�ce:and
3: Is improved,installed or re�laced by che hozneowner or licensed contractor.
Skip next section,if this applies; Cost of�ernait � 15.00
State Stuck►axge $ I.00
MAiI-In Fee(Zif,Applicabae) $ 2.00
TotaN Permit Fee �
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,If above does not apply;follow guideli�aes below:
a. CONTRACT PRICE *is 1.25%of contract price with a(Minimnm�'ee o�S50.OU)
�✓�� • 7�_0125$ r ��
����pna) (min4mum 550.00)
2. �'1 L�ITF.�'uURC.�uficrlF. /� � �r /
^ ���-� X_000s $ " �
(comract yricc>
3. POS�',A,G�&HANDLING(Qnly om N�ail-Tn Appkicacions) $ �gg�
4. TOTAL�EI.tJ.V�T FEE(Add Lin�es 1-3 Above) $ r
� ` CO�1'CRAC'T PRICE or JOB CaST means the actua] ox estimated dollar annount ck�arged for the
pecxnitted w�ork including z�aaterials,labor,pro�E'it,amd other fixed costs. It is the anr�ou�at Fo be chazged
to the custoaonor for the work done. Zf smy rnaterial, equi�me�pt,labot'or 'vastallations are furraisk�ed by
the awner, tenant o�c suy other psrty,the�easonable msrlcet value of suckt ite�s tnust bc added to the �
estYmated cost oc co�ntract priee for pezanit fee �urposes_ In the even,t that there is a dispute on the
amount of t�,e job aost, thc City znay request thc sub�.ission of a signed eopy o;F tl�e actual contract
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Tlae undersig�ned k�e�reby applies to t�ie Ciry for issuance of a Meehanical Perr�,it, agrees to do all
woxk iu� strict acco�ee with the ozd:unances of the C�ty aud the regulations of thc State of
Miautesota, az�d eertifies that a�� statements made o� this application are caz►a�lete, true and
correct.
, � ��
.A,pplicant's signatu�e: � Date:
3
� ��
DA TIMEV
CITY OF ORONO CALLED IN J�'9 " ��
INSPECTION N TIC /� �HEDULED �j //-/(� /O:
PERMR NO. �� `�—� GOMPL ED '
ADDRESS ' �h Q�`��
OWNER TE H E aO.�a�7�" �l�
CONTRACTOR � ' �`�E�J�
� DESCRIPTION a� v �/v
4� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
� ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING �uIECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OMINERlCONTNACTOR TO MEET YWI:_YES_NO
y COMMENTS:
W ,./ �
� f/ l� ►'sD�• - c�R.t%�G rero.r� �
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� -" �'��r- r�,EJ!• ' c,x�sti•r,f �ES /s,r�. �-
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� �jCIC�/Ks /I�(�r� ��'�Tt !/Git� �
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� �.Jo�'K �'on-re%�� -
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� ❑WORK SATISFACTOFlIF PROCEED OJECT COMPLETE
W ❑CORRECT WORK 3 PROCEED ❑I UE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECONERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP OROER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Csll forthe next inspection 2a hours in advance. (952) 249-4600
OwnerlCoMraCtor on site• C �R�- L�reyL`�.r.
inspector: w
White CopyllnspectoPs Fik Canary CopyfSNe Notk:e