HomeMy WebLinkAbout2004-P07688 - mechanical ~ �� ' PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P07688
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued: ��s�2ooa
SITE ADDRESS: 4423 North Shore Dr
MOUND,MN 55364
P I D: 07-117-23-34-0001
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Mechanical Permits Permit Sub-type(s): Multiple Mechanical Items
DETAILS:
Approved per resolurion#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 66.19 Valuation• $ 5,295.00
State Surcharge Fee: $ 2.65
TOTAL FEE: $ 68.84
APPLICANT: Countryside Heating&Cooling OWNER: J A MILLER&E N MII.,LER
6511 Hwy 1 Z 4423 NORT'H SHORE DR
Maple Plain,MN 55359 MOUND MN 55364
'TI�UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IlVIPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICf COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINrIESOTA BUII,DING CODE REQUIREMIIVTS.
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APPLICANT PERMTIBE SIGNATURE ISSUED BY SIGNATURE
Cooies: 1-File(Signitures ReAuiredJ, 1-Avplicant,l-Monthlv Revorts,l-Assessing,l-Finance Page 1
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CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT
Box 66 (2750 Ke11ey Parkway)
Crystal Bay, MN 55323
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. Perinit 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 Desi�ns - Complete calculations, details and specifications are required for each
heating, ventilation, humidification-dehumidificarion, and air conditioning installation
including heat loss/heat gain calculation, design teinperatures, equipment ratings and
identification as to type, manufacturer and model. Data shall be presented on form provided.
Identification of and specifications for water heating equipment shall also be 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-hour notice
required.
7. House Heating Test Record must be submitted before final.
Instructions
Complete all items on this application. Compute the permit fee. Sign and datc the
certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you
have questions, call(952) 249-4600.
Please check one: New Addition Repair V xeplace
✓�esidential Commercial
Jos siTE: 4�5��3 ti�� � �.Sf��'cT ��a z�p:
Owner's Name: � /V..I �LC:.IQ_, Phone Number: /S a—�f 7� —�7$7c /
Mailing Address: ���3 �JF Sf/�L(.-U/L City: ,/�/Ci�/�� Zip:
Contractor's Name: �Q(,fikNy���� Phone Number: 7 �.�'�� '�'1 '�6�� U
Mailing Address: �j// �c7 l 7— City: /l�itfc L �c.��.�✓Zip: _�359
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SYSTEM DESCRIPTION
HEATING SYSTEMS
Quantity:
Make: (
Model: � Y�7��/�
Fuel: /� - � .
Flue Size:
Input BTUs: �
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity: �
Make: �� �//"�
ModeL• ��������
Tons: �"'
H.Power
FIREPLACES
Gas factory fireplace
Wood burning factory fireplace with flue
_ Wood Stove
Wood stove with flue
Brand Name Model No.
VENTILATION
No. Kitchen Exhaust duct recalculating cfm
No. Bath Exhaust(must have duct outside) cfm
No. Other Fans: Locations cfm
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation or Removal
Fuel oil: gallons underground inside or outside
LP Gas: gallons
Other Gas opening
� . � .
PERMIT FEE CALCULATION(S)
2002 State Statute 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; excludin�the cost of the fixture or appliance:
and
3) Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee $ 1.50
If above does not apply, follow guidelines below:
1. Contract Price* is .0125% of job with a Minimum Fee of($35.00)
J�q�`�� X .ol2s � � �, %�I
(contract pricc) (minimum$35.00)
2. State Surcharge. ** Add the State Building Code Division a Minimum Fee of($ .50)
> � � �
��y�x .0005 $ �' � S
(contract price) (minimum$.50)
3. Posta�e and Handlin�(Only mail-in applications) � 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ l.(� 0 � ��
*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 installation is furnished by thc 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 STATE SURCHARGE is.0005 of the contract price under$1,000,000 or$.50-whichever is greater.For
valuations over$1,000,000 call the Department of Inspectional Services for the price.
The undersigned hereby applies to the Ciry for issuan�e of a Mechanical Permit,agrees to do all work in strict
accordance with the ordinances of the City and th e,�ul ��ns of the Minnesota State Building Code,and certifies that
all statcments made on this applic tion ar co e ; e�and correct.
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Applicant's Signature: C� Date: � � �/
Approved By: Date:
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