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HomeMy WebLinkAbout1991-004020 - mechanical PERMIT PERMIT TYPE: r. MECHANICAL) 0040.211" Permit Number:. Date Issued: y F OR°N°o. Box 66 10/16/.:41 IT - 0 Rd. South •_P:...._. BAY RD 335 Brown — CRYSTAL BA OLD stal Bay, -672) 473-7357 Minnesota 553zo 1100 D. D RESS: 1 BRyANT. 000 -,'74—14—0001 HAKE 110, 17--- N. ; 09-1 ei- SYS GAS INPUT HT—,? . . ;' ''''' ' ,-.: ., - ), , :_ , .1:10 IIPTI°N: .....:: FUEL --, ' - 4 41- MODEL HEATING SYSTEM__ OrfONO CITY OF . r OFFICE FINANC1- 1.7t3.7()grgEN 30.00 1700000 135 01 EN 1.50 KS: no}10/0 0 s .50 1,,,,,,,1• • gEN 31 00 ..,IZA.,-&- ' IL bill imbl%RECEIPTTHANK T14:07 imA1 ,- "v91 vimARY: `.26540 Livv 104 #4. $30•00 TMIADt•IaLl IN 1-5Q $30.50 se Fee r charge btota 1 1RD S R• riviNE • ..., NIT GUM t. -- __ Applicant. 1100..3,,,,...- - - ORONO OLD CRYR:IME:3;NBTAELR.:5:5:::::Y3NTs h CO AVECTOR: _ ,nM Hvi.... b, A.-"s6 - ' 'I IT FRED GORHH MN St'44 i I t'ir T T‘I LI r'FAL . ' • I C 1 ' I '0 - PARK . i•-r. -' jr-Fr‘--. .7•,-1.4 ,6iI—- lAIsc -NiF W11:-: ENTS- LOUIS PARK - -Tc,siON TIT! irrimpLIHI'--,-...-,-..UIRtM 4=i—b 2.) 171 c- -.1L17-'=P.:', Pi-i-Cr".-.1-1 c.,TRIC' ,1.: -:; r. -,s45.7Ff4't .T' ri'..- -:---' - mir,I.K ii'.... .-ruiLDI''''' • Fii2FNE-E:. r\---; ALL 'fl,-,,.., .:.;0";i'l c..,- - 'c-. Ll --- - Tyl DI- ?.e. i.,4.4t.-- , r.,,f,E;I:t--Jz‘I-- ic...L.= 1 - ..--r ;-ii- ) I-. f...)f3.7-c' --.1i) Atrs-, ,, s;11-1 I C. - '1.(4, 1... r-c, f-i!'-i.. . .. c pl,..4., •- . By SIGNATURE CII- 1*-1Nr;N(1.1.-' ISSUED Clh'ki ' . .., APPLICANT/PERMITEE SIGNATURE CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT GENERAL INFORMATION 1. You may apply for mechanical permits by mail or in person at the City offices. Mailed-in permits are subject to the postage and handling fees shown below. 2 . Permit cards will be sent by return mail the same day the application is received. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. When any new construction or remodeling is involved, a separate building permit must be obtained. 4 . All work must be done in accordance with State Building Code requirements. 5. All work must be inspected (rough-in and filal). Call 473-7357. 24-hour notice required. 6 . House Heating Test Record must be submitted before final. IN TRUCTIONS Complete all items on this application. Compute the permit fee. Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 473-7357. WALK-IN PERMITS apply at City Offices, 1335 South Brown Road (Cty. Rd 146) MAIL-IN PERMITS enclose fee - Mail to: P.O. Box 66 , Crystal Bay, MN 55323 ******************************************************************************** Please check one: New Addition Repair )( Replace JOB SITE: \N.) S . OIACVN E"aE( Q(Aq eLk Zip: 5 5-.3C1 Owner' s Name: D. Telephone Number: Mailing Address : VOC 4111 City: Zip: Contractor ' s Name: UMemomms. Telephone Number: SPRONSTAM Mailing Address gngn City: Zip: ********************* ******************************************************* MINIMUM FEE ( $30. 00 per project) ******************************************************************************** SYSTEM DESCRIPTION: $15 . 00 each unit Heating Systems : Quantity: _ Make: ,°-t ( - Meae7 : 3 is \\HCl Fuel: Cock ) Flue Size: Input BTUs : \\U m_ Output BTUs : CFM: ******************************************************************************** Cooling Systems : Quantity: Make: Model: Tons: H.Power: ******************************************************************************** , INF *WOOD BURNING EQUIPMENT $15.00 each unit -7 . ..._._ Wood stove with flue Wood combination or add-on unit Factory fireplace with flue Factor Fireplace (s ) _ freestanding Masonry Wood Stove (s ) franklin, other BrandName Model No. Mfgr' s Min. , Clearances, side , rear , min. flue dia. Total ******************************************************************************** VENTILATION $15. 00 each project No. Kitchen Exhaust ducted recirculating cfm No. Bath Exhaust (must be ducted outside ) cfm No. Other Fans: Locations cfm Total ******************************************************************************** FUEL STORAGE (must be approved by fire marshal ) . $30 . 00 Permanent/Temporary Fuel oil, gallons underground inside outside LP Gas , gallons Other Gas opening ******************************************************************************** GAS LINE INSPECTION High/Low Pressure $15 . 00 ***********icy+:******************************************************************* PERMIT FEE CALCULATION 1 . Total of above Installations or Minimum Fee ($30.00 ) $ 2 . State Surcharge. Add the State Building Code Division Surcharge to each permit $ . 50 3 . Postage and Handling on all mailed-in applications , $ 1 . 50 4 . TOTAL PERMIT FEE add lines 1-3 above $ _ The undersigned hereby applies to the City of issuance of a Mechanical Permit, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the Minnesota State Building Code, and certifies that all statements made on this application are complete, true and correct. Applicant' s Signature: 1 � , \. _..k, v\ Date: 07 - I -r - ( ) / . r } 6} : bb Yx 51$) HOUSE HEATING TEST RECORD Pettort-*I. Lt o2-0 ADDRESS 1100 8, OLD Ci I (5R0140APT. FLOOR CITY SUBURB RO1'JQ OCCUPANT OWNER HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY 1 0 6FrT7 NG Electrical Work By Gas Line By TYPE OF HEAT GA FA ,___HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE Q s'1 AI- MAKE OF BURNER Model 3 1 D 0 4%I OQ Model Serial 3 V 1 1;01401 Z Q 40 7 Max. BTU Rating INPUT i 0 (OC MAKE OF FURNACE Model CONTROLS 3 1, P v Ic THERMOST4T ,FCI Heat Plug Vent Size Valve f6 E CI KIND OF LINER SIZE NONE YY Limit 36TH IG 3 Draft Hood,De ACT" Fite 4 Regularor t r P Limit Setting I O Af' Filters Size E A■ Cd Number I Fan Setting Tfli E.Q ,� Chimney Location Insiide'j,`,X Outside r'`i Pilot Type S Yru< IQ� `` ON Chimney Construction 1 Y C. Pilot Make Pilot Model Smoke Bomb Wiring v Pilot Timing Draft }A ' FI I..1 Test Tag N L.W. Cut Off A Door Pressure Lighting Ins Pressure 3.51)S Percent CO2v Date Tested q , .Input CFH 1 I 0 000 Percent 0261 9 Company Testing &T E1 11 G Stack Temp. 106" Percent CO b'O Name of Tester 1"1 1'11 1.- Form Form 235 ,,.....�..._;._:•..,,T�qq,,,-wwvapY+:�' ' . ..-",. ,......,...�y.T"T"st' a+'P4*'elli ... A�'Tl �e••n•rs*^-.ry•r---..+s-s`. rr—_ -r �.. 410 W. LAKE ST. 1072 PAYNE AVE. MINNEAPOLIS, MN 55408-2998 ccemEm33 ST. PAUL, MN 55101-3892 612/824-2656 HEATING AND AIR CONDITIONING CO 612/772-2449 "Serving The Twin Cities Since!930" 1 / ORSAT TEST RECORD ADDRESS // oo air C,ysTG<- / / .- /WtCITY r r ,h p OCCUPANT OWN R / rt AOr r / AL e% t DATE HTG. INST. I TALLED BYIP-A-Gaee..-- -tom . r GAS LINE BY S ,,9 6' ®c -tot-4 TYPE OF HEAT: GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE /*(4,---7 MAKE OF BURNER MODEL 3 so iiri0 ir/isa MODEL SERIAL (104/9‘0 MAX. BTU RATING INPUT �00VOQ MAKE OF FURNACE CONTROLS MODEL THERMOSTAT HEAT PLUG � VENT SIZE 2 VALVE h,.4 KIND OF LINER /36 SIZE a NONE LIMIT ,cle,•t-c o DRAFT HOOD --v REGULATOR LIMIT SETTING 2 SO CHIMNEY CONSTRUCTION p't/G FAN SETTING T k DRAFT/C?I 4. St TEST TAG Ov ►,r/;;'- PILOT TYPE 6/90-7-4 LIGHTING INST. © �L PILOT MAKE a,A PILOT MODEL PILOT TIMING 77-Csw r PRESSURE r SP-' PERCENT CO2 5^ DATE TESTED /o - .6 INPUT CFH PERCENT 02 /0 Ale STACK TEMP. (0 o PERCENT CO //It'', NAME OF TESTER Imilhei //