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HomeMy WebLinkAbout2017-01378 - gas line only CITY OF ORONO * 2017 - 01378 * 2750 KELLEY PARKWAY DATE ISSUED: 10/23/2017 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 765 BRIDGEWATER DR PIN : 33-118-23-12-0090 LEGAL DESC : STONEBAY SEVENTH ADDITION : LOT 3 BLOCK 1 PERMIT TYPE : MECHANICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GAS LINE ONLY VALUATION : $ 1,200.00 NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. (I)RANGE,(1)DRYER(2)FIREPLACES APPLICANT MECHANICAL 50.00 SCHULTIES PLUMBING STATE SURCHARGE MECH(VALUATION) 0.60 1521 94TH LANE NE TOTAL 50.60 BLAINE,MN 55449 Payment(s) (651)786-4007 CREDIT CARD 6777 50.60 Minnesota State License#:plbg-PC644177,mech-MB005379 OWNER Wooddale Builders Inc 6117 BLUE CIRCLE DR UNIT#101 MINNETONKA,MN 55343- 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 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 • i e for due cause. A-•t.li ant P -- gnature Date Issued By Signature Date 10/23/2017 11:36 7632592299 SCHULTIES PLUMBING PAGE 02/04 • FC:ittaT'Y TJSE:ONLY. O City of Orono P .Box 66 Bate Received' ; , ..;Jhir fl 7,2, �. 2750 Kelley Parkway /� 1. Crystal Bay,MN 5523 Approled By_ ;Atno)liit:$: �U! Phone(952)249-4600 Fax(952)249-4616., ., �,r�EsFtpottp.rN �tic' CiTY OF ORONO—MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL'.INFOR.l+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 he 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. Ivlechanical_Designs—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 form provided. 4. When any new construction or remodeling is involved,a separate building permit must he 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)2494600. (24-48 hour notice required) 7. House.Heating Test Record must he submitted before final. TYPE:OF PERMIT ' Check All That A...1 ) . . .. Residential 0 Commercial(Approval Required) [Backflow Device:0 AVB ©.PVI3] 'New ❑ Additional El Repairs 0 Replace 16.0 Itt V 9tekitek aItbrni tion: Site Address: 745 Z5e1-++�ita r Owner: r, Mailing Address: / LX44.44.441,—, City: ^, ,,CLC& Zip: 5 355 Home Phone: 2 —3-Cif Alternate Phone: cctr*etor anformatioh:;; - Contractor: _.1 .�,,, ,ir, , ,. Contact Person: gitsai.,,,,,_ ir Address: it ' .,,I...,40::_,,,_• A' State Bond#: . O5. 71 City: Zip;; Expiration Date: g/a */5 Phone: .63r77.G--41607 Alternate Phone: MInsurance—Current: I 10/23/2017 11:36 7632592299 SCHULTIES PLUMBING PAGE 03/04 ]T✓((lk�l��ll�l�j�fl i�i't,'�ll�1iiM �,:rJ�.�i F...rrm �l'.o tl ] 1 r t .. �, n b 9 j� 1�,1��»'1 'i i S, S Lair,' Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. IS THIS GEOTHERMAL? ❑Yes 'RNo HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: Input BTUs: Output BTUs: CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: I-I.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 cfrn ❑ No. Bath Exhaust(must have duct outside) cfni ❑ No. Other Fans: Locations can FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.) ❑ Installation 0 Removal Fuel Oil: gallons ❑ Underground 0 Inside ❑Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill Other/List What&Where: /"'iect--175,/ //' Z 2li -r�-�...L/.� 10/23/2017 11:36 7632592299 SCHULTIES PLUMBING PAGE 04/04 isi i 4r f4i+ 'ili .{1+A i 4,'Niia.t;41,,ltiiii' .1, i,.,, ,a '''11 !. '? r' '., .i'iitoq;illi 41iii tt ! .1 Pd 1, CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) x.0]25$ 50a) ( ntrmct price) (minimum 550.00) 2. $TATE SURCHARGE Qi x.0005 $ ,r yortract price) 3. POSTAGE&HANDLING(Only on Mail-1n Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 5.2 SOV • * 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. 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 • made on this application are complete,true and correct. II. t Applicant's Signature. At Date: /96-0296 r 3