HomeMy WebLinkAbout2008-00247 - mechanical CITY OF ORONO PERMIT NO.: 2008-00247
2750 KELLEY PARKWAY
• ORONO,MN 55356- DATE ISSUED: 10/13/2008
(952)249-4600 FAX: (952)249-4616
ADDRESS : 1100 OLD CRYSTAL BAY RD S
PIN : 09-117-23-14-0001
LEGAL DESC : UNPLATTED 09 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : MECHANICAL-MULTIPLE
VALUATION : $ 52,000.00
NOTE:
INSTALL 2 GEOTHERMAL WATERFURNACES, 1 WATERFURNACE A/C 5 TON
1 BATH FAN
APPLICANT MECHANICAL 650.00
UMR GEOTHERMAL
5115 INDUSTRIAL STREET STATE SURCHARGE MECH(VALUATION) 26.00
MAPLE PLAIN,MN 55359 MAIL-IN FEE 1.50
(763)479-6325 TOTAL 677.50
OWNER
GRAHAM,ROBERT GUMNIT AND FRANCES
P.O.BOX 85
CRYSTAL BAY,MN 55323-
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.
67 /D I8
Applicant Permitee Signature /Date /
Issued Byg•gnature r I I Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBE Dr;.BOVE.
/g. 1
• FOR CITY USE ONLY
('o
City of OronoP.O.Box 66 Date Received. Permit#' , „ + 2750 Kelley Parkway
t ! Crystal Bay,MN 55323 Approved By: e J• Amount$:
\\74, , '.4,....s,,,i,),& (952)249-4600
CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
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. 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.
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. iA
(24-48 hour notice required) s %
sep
7. House Heating Test Record must be submitted before final. i/
7 ca
TYPE OF PERMIT
(Check All That Apply) c/T1'Of ��
OR0N
EResidential ❑Commercial(Approval Required) 0
0 New ❑Additional ❑ Repairs ❑ Replace
Job Site/Owner Information:
Site Address: 1100 Old Crystal Bay Road
Owner: Frances Graham Mailing Address: 1 100 Old Crystal Bay Road
City: Orono 55391
Zip:
P:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: UMR Geothermal Pat Person: Pat Hughes
Address: 5115 Industrial Street State Bond#: 929289728
City: Maple Plain Zip. 55359 09/16/08
Expiration Date:
Phone: (763)479-6325 Alternate Phone: (651)336-9445
09/01/09
❑✓ Insurance—Current:
1
•
MECHANICAL SYSTEMS BEING INSTALLED
HEATING SYSTEMS
Quantity: 1 1
Make: WaterFurnace WaterFurnace
Model: SDV064 EW042
Fuel: Electric Electric
Flue Size: N/A N/A
Input BTUs: 64,000 42,000
Output BTUs: 64
,000 42,000
CFM: 2,000
COOLING SYSTEMS
Quantity:
WaterFumace
Make:
Model: SDV064
Tons:
5
H.Power
FIREPLACES
❑ Gas Factory Fireplace
❑ Wood Burning Fireplace
❑ Wood Stove
❑ Wood Stove With Flue
Brand Name: Model No.:
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑,• No. 1 Bath Exhaust(must have duct outside) 500 cfm
O No. Other Fans: Locations cfm
FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL)
❑ Installation 0 Removal
Fuel Oil: gallons ❑ Underground 0 Inside 0 Outside
LP Gas: gallons
Other:
GAS LINE ONLY
O Outdoor Grill 0 Other/List What&Where:
2
•
1 , ;: PERMIT FEE CALCULATIONS)
'-" , 'Nit .., BASED OFF-2002 STATE STATUE
❑ 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;excluding the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $
PELMITTEE CALCULATION(S) JOBS OVER$500.00
If above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00)
52,000.00 x .0125 $ 650.00
(contract price) (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
52,000.00 x.0005 $ 26'00
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
677.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
• * 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 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 Building Department at(952)249-4600 for the price.
CAL'PERMIT APPLICATION AGREEMENT
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.
P / I�O
Applicant's Signature: / ,/, �� Date: J'/1---1--) V/1
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Rese,, :,--- Forrn
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6ep. 10. 1: 2911M No. 3504 P. 1
•
fANME5OTA DEPARTMENT OP lit '
n�.i.P os
t LABOR&INDUSTRY sou' INDUSTRY
Construction Codes and Licensing Division Construction Codas and Licensing Division
Commissioner of Labor and Industry
Commissioner of Labor and Industry Has Received and Filed a 325,000 Surety Boed,
Has Received and Filed a$25,000 Surety Bond, As Required by MS 326.992,for Work Regulated
tl Code
As Required by MS 326.992,for Work Regulated To; Roberta J.Henby heStau Mabaoi Bo d No: 929289728
by the State Mechanical Code IMR Geothermal MB ID:00594
Effective Date Expiration Date
To: Roberta J.Henrich Bond No: 929289728 9/17/2008 9/162009
UMR Geothermal MB ID: 00594
5115 Industrial St.
Maple Plain MN 55359
Effective Date Expiration Date
9/17/2008 9/16/2009 MBFormRC
Monica Fadness
From: mn@occinc.com
Sent: Friday, October 03, 2008 9:17 AM
To: locate
Subject: LORQ ROUTINE 80550386
Ticket No: 80550386 LORQ ROUTINE
Send To: CORONO01 Seq No: 4 Map Ref:
Transmit Date: 10/03/08 Time: 9:16 AM Op: webusr
Original Call Date: 10/03/08 Time: 8:33 AM Op: webusr
Work to Begin Date: 10/07/08 Time: 8:45 AM
Company : BERGERSON-CASWELL, INC.
Contact Name: SUE Phone: (763)479-3121
Alt. Contact: DAVE NEEDHAM Phone: (763)479-3121 (/
Type of Work: INSTALLATION OF A GEOTHERMAL WELL FIELD Work Being Done For: FRANCES GRAHAM
Explosives: N Duration: 1 WEEK R.O.W: N HDD: N
State: MN County: HENNEPIN Place: ORONO CITY
Address: 1100 Street: OLD CRYSTAL BAY ROAD
Nearest Intersecting Street: NORTH SHORE DRIVE Location of Work: MARK ENTIRE LOT
Remarks: CALLER REQUESTS LOCATOR USE PAINT AND FLAGS
Twp: 117N Rng: 23W Sect-Qtr: 109-NE
Twp: Rng: Sect-Qtr:
METWAS01 MINGAS05 MNDCBLO1 QLNMN03 XCEL08
1
09/25/2008 10:16 FAX 7634792183 BERGERSON CASWELL INC Z 0 0 2
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/QL DAA TIME
CITY OF ORONO CALLED IN
INSPECTION N TIC�p SCHEDULED D Z —27g o?-�O40
PERMIT NO. of --602�j-"7MPLETED /
ADDRESS I/O 6) Old 'A,Q Aw S";OWNER TR. 8ct e
TELEPHONE NO. �AR 99'e /V 7_3
DESCRIPTION�/� /Z
4, 0 FOOTING 0 MECHANICAL RI ❑ AV/GRADING/FILLING
Q El FRAMING ❑ MECHANICAL FINAL 0 ESHORE/WETLANDS
y 0 INSULATION 0 WOOD BURNER/FIREPLACE
0 TREE REMOVAL
Z
0 WALL BD. ❑ WATER HOOK-UP 0 SITE INSPECTION
Q El FINAL ❑ SEWER HOOK-UP 0 PROGRESS
0 DEMO-SITE 0 SEPTIC MAINT. 0 COMPLAINT
v 0 DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
0 PLUMBING RI 0 SEPTIC FINAL ❑ HARD COVER REMOVAL
v 0 PLUMBING FINAL 0 FOUNDATION/REMOVAL
IC 2 OWNER/CONTRACTOR TO MEET YOU: YES_NO
c0., COMMENTS:
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21 WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑ ORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
El CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on sit
Inspector.
White Copynnspector's File Canary Copy/Site Notice
DATE TIME
C
CITY OF ORONO CALLED IN
INSPECTION NOTE 2'-S7CHEDULED %d .L. "36--g 9'.�4
PERMIT NO. c OO 2 T COMPLETED
ADDRESS 1100 G f(- (2 -' acuied
OWNER "01- ct-NN., CONTR. tL'v .,t Cmc) rivinua
TELEPHONE NO. q�' c: - b - ?O 10)—
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-.E DESCRIPTION gac a^6 ddb I - plc
• ❑ FOOTING ❑ MECHANICAL RI 0 EXCAV/GRADING/FILLIN
Q 0 FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
0 TREE REMOVAL
• ❑ WALL BD. 0 WATER HOOK-UP 0 SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
❑ DEMO-SITE 0 SEPTIC MAINT. 0 COMPLAINT
✓ 0 DEMO-FINAL ❑ SEPTIC INSTALL. 0 FOLLOW-UP
❑ PLUMBING RI 0 SEPTIC FINAL 0 HARD COVER REMOVAL
❑ PLUMBING FINAL 0 FOUNDATION/REMOVAL
• OWNER/CONTRACTOR TO MEET YOU:_YES_NO
r.)• COMMENTS:
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Fuj WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
CC
W ❑ RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
CZ 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN
INSPECTOR WILL RETURN
0 CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspect'.n 24 hours in advance. (952) 249-4600
Owner/Contractor on -te: _
Inspector. f A
White Copy/Inspector's File Canary Copy/Site Notice
DTE TIME L
CITY OF ORONO CALLED IN /-�o
INSPECTION NOTICE _/SCHEDULED 02-02 I E3.
PERMIT NO. O -0002q ` COMPLETED
ADDRESS I100 D O., Ia ed -s-
OWNER
OWNER , CONTR. �G'
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TELEPHONE NO. 9S 1 Z'5 I � `l5b'
DESCRIPTION (I—1 hJ -
LLJ ❑ FOOTING ❑ MECHANICAL RI ❑�EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL LAKESHORE/WETLANDS
CI) ❑ INSULATION 0 WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP 0 SITE INSPECTION
0 FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
0 DEMO-SITE ❑ SEPTIC MAINT. 0 COMPLAINT
v 0 DEMO-FINAL 0 SEPTIC INSTALL. ❑ FOLLOW-UP
LU 0 PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
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• ❑WORK SATISFACTORY:PROCEED ROJECT COMPLETE
• ❑CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
C) El CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor o site �a
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice