HomeMy WebLinkAbout2000-P02146 - mechanical PERMIT
CITY OF ORONO PERMIT TYPE: Mechanical
2750 Kelley Parkway - P.O. Box 66 Permit Number :Po of Cyto
Crystal Bay, Minnesota 55323 Date Issued: 01/07/00
(612) 249-4600
SITE ADDRESS: 1100 Old Crystal Bay Road
Orono, MN 55356
H.N.B.
09-117-23-14 0001
DESCRIPTION: Mechanical
1 Cooling System Make Bryant 3 %2 Tons
REMARKS:
FEE SUMMARY: Valuation $1,500
Base Fee $35.69 MAIL IN FEE $1.50
Surcharge $1.43 Total Fee $38.62
Subtotal $37.12
CONTRACTOR: Standard Heating& A/C Co. OWNER: Robert Gumnit
410 West Lake Street 1100 Old Crystal Bay Road
Minneapolis, MN 55408 Orono, MN 55391
THE UNDERSIGNED HEREBY REQUEST PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND
AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
Crr) Vi0- 0274610
APPLICANT/PE ITEE SIGNATURE ISSUED BY: SIGNATURE ehs....„
EECEI ED ;
CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT
Box 66 (2750 Kelley 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 2 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. 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. 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 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 date the certification.
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 249-4600.
Please check one: New Addition Repair Replace
Residential Co er ial
JOB SITE: (/&C) O(ce _ T 4 P �, rQ Zip:SS cC
Owner's Name: e)bc Telephone Number: - (d
Mailing Address: C ) groj" L �� f O1o' SP:
Contractor's Nae: 410 WEST . elephone
Number:
Mailing Address: mous,MN S54082996 City: Zip:
111z-11Z4-2:::35
SYSTEM DESCRIPTION
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model: ,,
Tons:
H. Power
WOOD BURNING EQUIPMENT
Wood stove with flue
Wood combination or add-on
Factory fireplace with flue
Factory Fireplace (s) Freestanding Masonry
Wood Stove (s) Franklin, other
Brand Name Model No.
Mfgr's MM., Clearances, side , rear , min. flue dia.
VENTILATION
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. Other Fans: Locations cfm
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation Removal
Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
" ' /x .0125 $ S l9Gr'
(contract price)
2. State Surcharge. ** Add the State Building Code Division L
Surcharge to each permit. x .0005 $ '`
or $.50, whichever is greater (contract price)
3. Postage and Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) .aa• (. �----
* 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 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 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 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 Minnesota
State Building Code, and certifies that all statement made on this application are complete, true
and correct.
Applicant's Signature: � Cr,�, Date: Z- (CC
PP g i
Approved By: Date:
410 W. LAKE ST. 1072 PAYNE AVE.
MINNEAPOLIS, MN 55408-2998MI:1=i) ST. PAUL, MN 55101-3892
612/824-2656 ' HEATING AND AIR CONDITIONING CO. 612/772-2449
�(� "cServine The Twin Corms Saxe 1930"
O "
L ORSAT TEST RECORD
ADDRESS J/Oo O`J C r15Tb"l/ X:k,y kei co CITY r 0 0
OCCUPANT OWNE I , ; z/ f ..e
DATE HTG. INST. NSTA LED BY ex-/ � , e
GAS LINE BY ) - 1
` 1J.5Ca-1iif-to:- i,
.,
TYPE OF HEAT: GA FA L' HW STEAM SPACE HTR. UNIT HTR. OTHER ,
[ GAS DESIGN CONVERSION
MAKE rt/ MAKE OF BURNER
MODEL 4'i3/ ' r,Y17// MODEL
' SERIAL .7 `(/4 7oL. MAX. BTU RATING
INPUT` f/Ol&o' MAKE OF FURNACE _
CONTROLS MODEL
THERMOSTAT - HEAT PLUG ( 4 VENT SIZE
VALVE Gt,;< KIND OF LINER <%c, :-f, .-.- SIZE7' NONE
LIMIT 5r'c'- ' DRAFT HOOD REGULATOR
LIMIT SETTING /it) CHIMNEY CONSTRUC ION iv (kJ-
FAN SETTING 7C e DRAFT G.- T5-.S] TAG Ol1cJ ,t.
PILOT TYPE �,‘,,�/� LIGHTING INST. 0900901-r(-141'
PILOT MAKE Lt,
PILOT MODEL /
PILOT TIMING .�1�"'L-t e,
PRESSURE ? , 5 , PERCENT CO2 DATE TESTED /1 ''2 5r.' ,.6
INPUT CFH ,!/a PERCENT 02 1'6
STACK TEMP. 177.0 PERCENT CO f.'-1 Or e- NAME OF TESTER ,.."7 / of.„1.- 'M-