HomeMy WebLinkAbout2017-00210 - mechanical , -� CITY OF ORONO * 2 0 1 7 - 0 0 z 1 0 *
2750 KELLEY PARKWAY DATE ISSUED: 03/07/2017
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 500 OXFORD RD
PIN : OS-117-23-41-0015
LEGAL DESC : STIELOWS ADDN
: LOT 007 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : HEATING SYSTEMS
VALUATION : $ 10,100.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
(1)NATURAL GAS NIT HEATMG SYSTEM
APPLICANT MECHANICAL 126.25
SODERLIN PLUMBING STATE SURCHARGE MECH(VALUATION) 5.05
3612 CEDAR AVE S MAIL-IN FEE 2.00
MINNEAPOLIS,MN 55407- TOTAL 133.30
(612)721-4080 Payment(s)
CHECK 42052 13330
OWNER
NELSON,ALBIN&SUSAN
500 OXFORD RD
LONG LAKE,MN 55356-
AGREEMEIYT 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 oniy the work described and dces
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 l80 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant P itee Signature Date Issued Signature Date
, , �---- �{C,(drtIVED FOR CITY[ISG ONLY
/ � City of Or000
� �- �� P.O.Box 66 ��� � � ���� Date Received: Permit#
2750 Kelley Park�vay
Crystal E3ay,MN 55323 Approved By: Amount$:
Phonc(952)249-4600 Fax(��24��
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��KES�Ho�```'� CITY OF ORONO—MECHANICAL PERMIT
� (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marsh�ll)
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 NO�I�
VALID UN"I�IL YOU R}:CI;IVE A PERMIT. WOIZK MUST NOT I3EGIN UNTIL THF
PFRMIT CARll IS POSTED ON THE J013 SITE.
3. Mechanical Desi�—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air eonditioning 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 donc in accordance with the Unifonn 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 I�leating Test Record must be submitted before final.
TYPE OF PERMIT
(Check All That A 1 )
�] Residential ❑ Commercial (Approval Required) [E3ackflow Device: ❑ AVB ❑ YVB]
❑ New ❑ Additional ❑ Repairs �Replace
Job Site/ Owner Information:
Site Address: J�!v ��`L%dL'�� ���%t� /J
Owner: JLC'� ��2-J�� Mailing Address: �% ��� U X�c�/e/� �2% ,
City: (�/�(:/�U Zip: _�� �i ��1v
Home Phone: '�/�� � �-f�-7� --J'�,�% � Alternate Phone:
Contractor Information:
Contractor: �u���72�--�� Contact Yerson: �.��/�-���
Address: �'(c�� �'E7�4-/z-����� State I3ond #: ��'1/,3�� 0 3 2 7,:?
City: /���/J.C_�� �� Zip: _5�/�'/`�_'xpiration Date: � f,�%�;2U l�?
Phone: �O/o� " �a� "��G��G�` Alternate Phone:
[�] Insurance—Current: �iti`�`�� /��7JD /'l')�C/-7�t/�
1
' ' MECHANICAL SYSTEMS BE1NG INSTALLED
Note: All Geothermal Systems will now require a Site Plan & Review by our I3uilding Ofticial.
IS THIS GEO'THERMAL? ❑ Yes �] No
HEATING SYS'I'EMS
Quantity: �� _
Make: /1l / %
Moa��: VM�X (�(�
r���l: C���-5
}�luc Size: �i�
Input E3TUs: //�,DG`� O
Output F3"I'Us: /DF, C�nC�--- —
CFM:
COOL[NG SYSTFMS
Quantity:
Make:
Model:
'I`ons:
H. Power - -- --
FIREYLACES
❑ Gas Factory Fireplace Brand Name:
❑ Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VEN"TILA"CION
❑ No. _ Kitchen Exhaust duct recirculating cfin
❑ No. Bath Exhaust(must have duct outside) _ cfm
❑ No. Other t�ans: Locations __ _ cfm
FUEL STOf2AGE (Must be approved by Fire Mars/�all if proposing to abanrlon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ lnside ❑ Outside
LP Gas: gallons
Other:
GAS LINF. ONLY
❑ Outdoor Grill ❑ Other/I.,ist What& Where:__
2
PERMIT F�E CALCULATIONS
1. CONTRACT YRICE * is 1.25%of contract price with a(Minimum Fee of�50.00)
%G', /L �% x .o125 $ 1��� �5
(contract price) (minimum SSOAO)
2. STATE SURCHARGE
/C�, /C=' O x .0005 $ ����� ��
(contract price)
3. POS"I'AGE& I-IANDLING (Only on Mail-In Applications) $ 2.00 _
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) � ���3� ��%
■ * CONTRACT PRICE or JOB COST means the acttial 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.
MECHANICAL PERMIT APPLICATION AGREEMENT
The undersigned hereby applies to the City for isstiance 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 co�nplete,true and correct.
Applicant's SignatLire: Date:
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