HomeMy WebLinkAbout2018-00058 - gas furance CITY OF ORONO 1 1 1 1 1 ,11, 1 1 1 1 1 1 1 1 111
* 2018 - 00058 *
2750 KELLEY PARKWAY DATE ISSUED: 01/18/2018
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 776 BROWN RD N
PIN : 34-118-23-11-0001
LEGAL DESC : REG.LAND SURVEY NO. 1275
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 4,041.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
(1)CARRIER NATURAL GAS FURNACE
APPLICANT MECHANICAL 50.51
FLARE HEATING&AIR COND STATE SURCHARGE MECH(VALUATION) 2.02
9309 PLYMOUTH AVE N MAIL-IN FEE 2.00
SUITE 104 TOTAL 54.53
GOLDEN VALLEY,MN 55427 Payment(s)
(763)542-1166 CREDIT CARD 0941 54.53
Minnesota State License#:mech-MB005424
OWNER
BARBARA LUIKENS,RICHARD BENSON/
776 BROWN RD N
LONG LAKE,MN 55356-
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 any time for due cause.
61/eUie-69 / f FI 122
Applicant Permitee Signature Date Issued By*nature Date
JAN/17/2018/WED 01 : 42 PM Flare Heating FAX No, 7635423101 P. 002
FOR. 111 SE ONLY
�r City of Orono z '
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P.O.Box 66 Datg. ' vF.d7 Peca>it# � •�5
2750 Kelley Parkway , ^ter �j
Crystal Bay,MN 55323 ' A roxed By Amount$ eJ
Phone(952)249-x600 Fax(952)249-46I6 ,
CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or inspector and/or Fire Marshall)
',GENERAL INFORMATION. ',,,..,,.., . .,
r`, s: s
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 UNTIE,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 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 be
obtained.
S. 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.
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iv Residential a Commercial(Approval Required) [Backflow Device: ❑AVB ❑PVBJ
❑ New ❑Additional ❑Repairs jiki'lleplace
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Owner: /d Set?`--Car? Mailing Address: G`/22,e
City: 4-"C"-SCoalZip: . S2SS [,2 .
Home Phone: Alternate Phone: 10_,---4D-94-1
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Contracto4J
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/T/ � Contact Person: T/2161--- or-!
Address: "111"-3,6/9mbei6t`te Bond#: ria00 S .)-y
City: ewith the/ 'i . Expiration Date: 7/.?i// ?-
Phone: 7 0� 70-""//z..0, Alternate Phone:
r4fInsurance-Current:
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JAN/17/2018/WED 01 : 42 PM Flare Heating FAX No. 7635423101 P. 003
,y !.y?2yyri, egraf fOrattA .01 0.100 eV!, ,QCT-LON,",.T._4 ‘ileti
Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? L]Yes A/No
HEATING SYSTEMS
Quantity:
Make:. Com" ( —
Model' //P 6P b/7 /7
Fuel: /1761f.
Flue Size: /')
Input BTUs: d:117
Output BTUs: —76/(POO _
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
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 cfrn
❑ No. Bath Exhaust(trust have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground 0 Inside ❑ Outside
LP Gas: gallons
Other;
GAS LINE ONLY
❑ Outdoor Grill [ Other/List What&Where:
2
JAN/17/2018/WED 01 :42 PM Flare Heating FAX No, 7635423101 P. 004
ANgtantanktraSIUMIAMZOMVIOAVAMMINaria
1, CONTRACT PRICE *is 1,25%of contract price with a(Minimum Fee of$50.00)
x.0125$ Com'•S-7
(cdtttrnct price) (minimum$50.00)
2. STATE SURCHARGE2h
/ V / x.0005 $ D
(coatract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 5 Y
■ * 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 fce 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.
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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 statements made on this application are complete,true and correct.
Applicant's Signature:
' / Date: // 7 //,
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DATE TIME Y
CITY OF ORONO CALLED IN
INSPECTION NOTICE Q SCHEDULED I//9 q /0 % op
PERMIT NO. 0,0 12 - C O s7" COMPLETED
ADDRESS -7--7(' �� i3 ren kd- _
OWNER _ !' &/TE yEPHOON��E NO. 9% 9-% 2 S
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CONTRACTOR ' Al C )J
EDESCRIPTION 6 Vfi /u4fl4'I(o '7
W 0 FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
r FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
GI Z ❑ RADON SLAB ❑ MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING -MECHANICAL FINAL 0 RATED WALLS
is ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q ❑ FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP 0 FOUNDATION/REMOVAL
✓ ❑ DEMO-SITE 0 SEPTIC INSTALL
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ONERICONTRACTOR TO MEET YOU:_YES_NO
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11.1• O WORK SATISFACTORY:PROCEED (ROJECT COMPLETE
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W CICORRECT WORK&PROCEED LI ISSUE CERTIFICATE OF OCCUPANCY
CI• 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. El PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. < //w _ii
White Copyllnspector's File Canary Copy/Site Notice