HomeMy WebLinkAbout2016-00063 - mechanical CITY OF ORONO
* 2016 - 00063 *
2750 KELLEY PARKWAY DATE ISSUED: 01/19/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952)2494616
ADDRESS : 205 NORTHGATE RD
PIN : 36-118-23-44-0016
LEGAL DESC : NORTHGATE TWO
: LOT 001 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 12,596.00
NOTE: (1)BRYANT FURNACE-NATURAL GAS-3"FLUE, 100,000 INPUT,96,000 OUTPUT
(1)A/C UNIT-4 TON
APPLICANT MECHANICAL 157.45
SABRE HEATING&AIR COND INC.
STATE SURCHARGE MECH(VALUATION) 6.30 15535 MEDINA ROAD MAIL-IN FEE 2.00
PLYMOUTH,MN 55447- TOTAL 165.75
(763)473-2267 Payment(s)
Minnesota State License#:mech-MB3392,plbg-PC645349 CREDIT CARD 9764 165.75
OWNER
ARNOLD,JOAN L
205 NORTHGATE RD
WAYZATA,NIN 55391-
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.
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Applicant Permitee Signature Date Issued PTgnature Date
01/19/2016 TUE 9: 26 FAX 763 473 8565 Sabre Heating & Air Cond 2002/004
City of
' R CrrY SIC ONLY
66 ��
P.O.Box 66 Dote Receive .� rnoit if -1 XJJ0
d Q 27511Xdlcy Parkway
Crystal Bay.MN 55)23 Approved y: Anstalt�:
Pinie(952)249.4600 ftx(952)249-0616
CITY Or ORONO—MECHANICAL PERMIT
(All Commercial pamits must be approved by the Building Oficial or Inspector exWor Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical petmits by mail or in person at the City offices. Applications wil l
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 AM NOT
._
VALID JJNTIL PERMIT WORK NOT NO'T U —IN UNTIL T1�E_ _
rE1RAHT CARD IS POST=-OR 1ftdos 9fM - -
3, nic 1 Desirg—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 R,acord must be submitted before final.
TYPE OF PERMIT
Check All That ApjgA
[residential ❑ Commercial(Approval Required)
El New C1 Additional ❑Repairs Oeplace
Job Site/Owner bafonnation:
Site Address: .24S No -JAI,
Owner: ➢►ir or" Mailing Address: 205 WA AAL. 4
city: �pt�j,a zip.
HornePhone- _�01'Z� 9A �F"I _ Alternate phone:
Contractor Informatiow
Contractor. W Contact Verson: oo
.�
Address: 155n A.kvl State Bond#: x-
City; Yft4in Zip: 11 Expiration Date:
Phone: �Vj-41 I_ 'Y Alternate Phone: -11 3-41 IK
D" Insurance--Current:
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01/19/2016 TUE 9: 26 FAx 763 473 9565 Sabre Heating & Air Cond X003/004
" ZQote�"AT1 GeoPlto x0Systems will now require a it Plan&Rgyjow by our Building Official.
IS TRIS GEOTHERMAL? ❑Yes 'No
BEATING SYSTEMS
Quantity: —
Make: jL -- —
Model:
Flue Size: 4
Input BTUs: NOW
OutputBTUs:
CFM:
COOLING SYSTEM
Make: .. ...._......
Model-
Tons-
14,
odel'Tons:I4.Power
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILATION
[] No. Kitchen Exhaust duct—recirculating cfm
❑ No. Bath Exhaust(must!Dave duct outside) cfiu
❑ No. Other Fans: Locations_ _ efin
BNFL STORAGE (Must be approved by Fire Marshall ijproposing to abandon tank in place,)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
L$Gas. gallons
Other:
❑ Outdoor Grill ❑ Other/hist What&Where;
I Z
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01/19/2016 TUE 9: 26 FAX 763 473 8565 Sabre Heating & Air Cond 0004/004
❑ Yes,this section applies
The replacement of a RC;jdV1tialW&&rg gr anolianCe that meets all three of the following requirements:
1. Dpesno require modification to electrical or gas service.
2. Pias a total cost of$500.00 or less;excluding the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Slnp noxi section,if this applies; Cost afPeimit $�� ��T5.0
State Surcharge $ 5.00
Mail-In Pee(If Applicable) $, ,_ ,2.00
ToW Permit Fee S
Millis
If above does not apply;follow guidelines below,
1. CO�$i a k= "is 1.25%of contract price with a(]Minimum Fee of$50.00)
-1(conlmetpncxi) (minimum SSO.00)
2. STA1;R% C ARA C.
(conaact pri-)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ -2,40
4. TOTAL P1 T PEE(Add bines 1-3 Above)
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" CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including mewials,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 crnrtract.
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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 comities that all statements made on this application are complete, true and
COMMA.
Applicant's Signature: Date: - )�t�l-Ullo
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