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Home My WebLink About2014-00802 - mechanical � CITY OF ORONO * 2 0 1 4 - B 0 8 0 z * � 2750 KELLEY PARKWAY DATE ISSUED: 07/29/2014 ORONO,MN 55356- 952)249-4600 FAX: (952)249-4616 ADDRESS : 4041 NORTH SHORE DR PIN : 07-117-23-44-0077 LEGAL DESC : REG.LAND SURVEY NO. 1420 : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : MECHANICAL-MULTIPLE VALUATION : $ 3,816.00 NOTE: 1 LENNOX 2 TON AC APPLICANT MECHANICAL 50.00 SEDGWICK HEATING&A/C STATE SURCHARGE MECH(VALUATION) 1.91 1408 NORTHI.AND DR-SUITE 310 1VIAIL-IN FEE 9.23 MENDOTA HEIGHTS,MN 55118- TOTAL 61.14 (952)881-9000 Payment(s) CHECK 15112 53.91 CHECK 15112 7.23 OWNER MCCURDY,DALE 4041 NORTH SHORE DR MOi1ND,MN 55364- AGREEMENT AND SWORN STATEMENT T'he 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 sepazate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if conswction 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 aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. ( / / Applicant Permitee Signature Date Issued By Si re � Date r _ -. �►� I�s lJd I • {� ,� FOR CITY USE ONLY � City of Orono . O4 '�O P•O.Box 66 Date Received: Permit# 2750 Kelley Pazkway � � -��. t Crystal Bay,MN 55323 ApProved By: Amount$: L„ ' d� Phone(952)249-4600 Fax(952)249-4616 .,Qs�� CITY OF ORONO—MECHANICAL PERMIT (All Coaunercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL INFORMATION 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 two working days. 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Designs—Complete calculations,details and specifications are required for each heating,ventilation,humidification-dehumidification,and air condirioning installation including heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to type,manufacturer and model. Data shall be presentPd on form provided. 4. When any new construcrion 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 fmal). Call(952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before fmal. TYPE OF PERMIT Check All That A 1 �]Residential ❑Commercial(Approval Required) ❑New ❑Additional ❑Repairs �Replace Job Site/Owner Information: Site Address: ��y'� 1V� S V I.UV�2. �• Owner� Mailing Address: ��'� �(/1i�/4 S�1,{j✓-2,�• c�ri: .��t.o z�p: 5 5 3Le� Home Phone: Alternate Phone: Contractor Information: � Contractor: �Q_G,�W�-u�-- �1�� Contact Person: � � Address: �4U� �v�i►�GU�.� �, State Bond#: City: ip: J�ZO Expiration Date: Phone: �5� �� Alternate Phone: �� Insurance—Current: 1 . ;,...; .°°,m ,1VT��HANICI� � T'�MS BEING�itT�T��.L�,�D `: ��,�o�o,. ��; Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official. IS THIS GEOTHERMAL? ❑Yes [�No HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: Input BT'Us: Output BT'Us: CFM: COOLING SYSTEMS Quantity: ` Make: Model: � 'ul�� Tons: /� H.Power FIREPLACES ❑ Gas Factory Fireplace Brand Name: ❑ Wood Burning Fireplace � ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTILATION ❑ No. Kitchen Exhaust duct recirculating cfin ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfin FUEL STORAGE (Must be approved by Fire Marshall df proposdng to abandon tank dn plac�) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List What&Where: 2 . • -• , • �� ' �' R:1VIIT FEE CAF,C�;A.�`TION(S} �� ° ` ,, , � �. �� BA��T�OFF=2002 ST;F�:�' ��TATUE � � �� :� ❑ Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance:and 3. Is improved,installed or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Permit $ I5.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ PERNIIT F�E CALCULATION S '=JOBS OVER$SOO.OU' If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) ,�� l 1�,(� x.0125$ �2 (contract price) (minimam$50. 0) 2. STATE SURCHARGE 3��, u� X.000s $ < < �. v (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �/I � �� ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials, labor,profit,and other fixed costs. It is the amount to be charged to the customer for the work done. If any material, equipment, labor or installations 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. MECHANICAL PERMIT APPLICATION AGREEMENT ' 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 sta.tements made on this application are complete, true and conect. Applicant's Signature: Date: � �,�j'� � Reset'Form 3 � � D TIME �� CITY OF ORONO CALLED IN �7' INSPECTION N�TIC SCHEDULED �� PERMIT NO. ��'U� "�D��COMPLETED � � ADDRE T�� OWNE HONE NO.��'�7a'7`4�� CONTRACTOR LG � DESCRIPTION ��io. � ❑ FOOTING 0 PLUMBING FINAL ❑ IXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATIOPI ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL � SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI � SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO h COMMENTS: � a �-/G tc n/4c�•r��g� — � 0 �. � . e_ �_Gf/`iGiL �e.ccn�.e�� -- o _ , , . Px �sti-,� �rin��.scr /in� _ W � °� ' �'�r�dle.t s�� :�� ,oc�/1��ia:�, ,L� ��9 Q � a � I,�orK �'ar�,��e�� W � � � �WORKSATISFACTORY:PHQ�EED ROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ISS ERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMAPIENT ❑CORRECTUNSAFECONDITIONWITNIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETItRM ❑STOP ORDER P0.STED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advanc�. (952) 249-46�� OwnerlContractor on site: �d 1�� Inspector. ��~`�� WhRe CopyMspector's File Canary CopylSlte Notice