HomeMy WebLinkAbout2011-00379 - cooling systems CITY OF ORONO PERMIT NO.: 2011-00379
2750 KELLEY PARKWAY
� ORONO,MN 55356- DATE ISSUED: 05/23/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 1399 PARK DR
PIN : 07-117-23-42-0012
LEGAL DESC : SAGA HILL REVISED
: LOT 016 BLOCK 006
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : COOLING SYSTEMS
VALUATION : $ 4,100.00
NOTE: 1 MITSUBISHI DUCT FREE 2 TON AC
APPLICANT MECHANICAL 51.25
STAFFORD HOME SERVICE INC. STATE SURCHARGE MECH(VALUATION) 2.05
6225 CAMBRIDGE STREET
ST LOUIS PARK,MN 5541Cr MAIL-IN FEE 2.00
(952)927-7194 MISC FEE 0.00
TOTAL 5530
OWNER
SIGEL, STEVEN&SHEILA
1399 PARK DR
MOUND,MN 55364
AGREEMENT AND SWORN STATEMENT
The wotk 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 goveming 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 tim/��cause.
� � � / ; /
Applicant Permitee Signature Date Issued By Si ture ate
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV .
, .
�t e[�Us�e Oxi.�
O$O�O City of Orono
P.O.Box 66 Date Iteoeived: �i#
, 2750 Kelley Parkway `
� . �.� Crystal Bay>MN 55323 Approvad By: �_„_A�u�tt$;
� Phone(952)249-4600 Fax(952)249-4616
CITY OF ORONO—MECHANICAL PERMIT
(All Commercial pertnits must be approved by the Building Official or Inspector and/or Fire Marshall)
���L�Q���Q� '
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 cazds will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECBIV$A PERMIT. WORK MUST NOT BEGIN UNTIL THF�
PERMIT CARD IS POSTED ON THE JO�SITE.
3. Mechanical�esi¢ns—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air conditioning installation including
he,at loss/heat gain calculation,design temperatures,equipment ratings and identification as to
type,manufacturer and model. Data shall be presented on form provided.
4. V/hen ac�y new constr��ction or remodeling is involved,a separate building permit must be
obtained.
5. All work must be done in accordance with the Uniform Mechanical Code/State$uilding Code
requirements.
6. All work must be inspected(rough-in and final). Call(952)249-4600.
(2448 hour notice required)
7. House Heating Test Record must be submitted before final.
TY�`F�?E FERMIT
Check All'That A 1
Q Residential ❑Commercial(Approval Required) �
❑New �■ Additional ❑Repairs ❑Replace
Jab Site f t�wner Information: `
Site Address: 1399 Park Drive
pwner:Steve Siegel Mailing Address: 1399 Park Drive
c;�,: Orono Z;p: 55364
Home Phone: (���-���Y�— �� � � Alternate Phone:
Contractar Information:
Contractor: Stafford Home Service Peggy
Contact Person:
Address:
6225 Cambridge Street State Bond#: LJ� �� ��
St. Louis Park 55416 � ' 3O � (
City: Zip: Expiration Date:
Phone: (952) 927-7194 Alternate Phone:
❑ Insurance—Current:
1
� Note:All Geothermal Systems will now require a Site Plan&Review by our Building pfficial.
IS THIS GEOTHERMAL? ❑Yes []■ No
HEATING SYSTEMS
Quantity:
Make:
ModeL•
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quai►tiry: �
o � �
Make: '-"
Model: rI/I U i �� �`-'n
Tons:
H.Power
FIREPLACFS
❑ Gas Factory Firepiace Brand Name:
O Wood Burning Fireplace
Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen Eachaust duct recircuiating cfin
❑ No. Bath Exhaust(must have duct outside) cfin
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by�re Marshall if proposing to abandon tank in plac�)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE NLY
❑ Outdoor Grill ❑ Other/List What&Where:
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I
❑ Yes,this section applies
The replacement of a Resi�ential fixture or appliance that meets all three of the following requirements:
1. ces not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludine 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 $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
If above dces not apply;follow guidelines below:
1. CONTRACT PWCE *is 1.25%of contract price with a(Minimum Fee of$50.00)
4,100.00 X.o12s$ 51 .25
(contract price) (minimam 550.00)
2. STATE SURCHARGE 4,100.00 2.�5
x.0005 $
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.Q0,
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $55.30
■ * CONTRACT PWCE or JOB COST means the actual or estimated dollaz 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 aze fumished 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.
T'he 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 t 11 statements made on this application are complete, true and
correct.
Applicant's Signature: �—� Date: �*' 1 / '" I �
� �e
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