HomeMy WebLinkAbout2015-00295 - mechanical ' ` CITY OF ORONO * Z 0 1 5 - 0 0 2 9 5 *
2750 KELLEY PARKWAY DATE ISSUED: 03/12/2015
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 3399 CRYSTAL BAY RD
pIN : 17-117-23-44-0021
LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B
: LOT 018 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 2,500.00
NOTE: TRAVIS GAS FACTORY FIREPLACE-MODEL#98500193
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.25
PRACTICAL SYSTEMS MAIL-IN FEE 2.00
4342B SHADY OAK RD
HOPKINS,MN 55343 TOTAL 53.25
(952)933-1868 Payment(s)
CREDIT CARD 5815 53.25
OWNER
V MCKINNEY,STEVE SOBIENIAK/
3399 CRYSTAL BAY RD
WAYZATA,MN 55391-
AGREEMENT AND SWORI�i 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
permiu. Ali 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 aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
!�/1Q.L� �� /�j/�
Applicant Permitee Signature ' Date Issued Signature Date
9529331869 13 36 26 03 12 2015 1 !3
OR TY U ONLY� �
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/ 2750 Kc11cy Parkway
! Crystal Day,MN 55323 Approved IIy: _Amaunt�:���
( �l, Phonc(952)249-4600 }=ax(952)249-a616
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f�',��1 t{���`' CITY OF ORONO—MECHANICAL PERMIT
(All Commercial perniits must be approved by rhe IIuilding Officiaf or Inspcc�or ancUor firc Marshall)
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in persoti at the City offices. Applications�vill
be reviewed and a permit wil!be issued within two working days.
2. Perrait cards will be sent by retum mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK NICJST NOT BEGIN UNTIL THE
PERMIT CARA IS POSTED ON THE JOB SITE.
3. Mechanical Desi�ns—Complete calculations,details and specifications are requircd for each
heating,ventilation,humiditication-dehumidification,and air condiEioning 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 ne�v construction or remodeling is involved,a separate building permit must be
obtained.
5. AI}work must be done in accordance�vith the Uniform Mechanical Code/State Building Code
requirements.
6. Atl work must be inspected�rough-in and final). Call(9S2)249-46Q0.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before tinal.
TYPE OF PERMIT
Check All That A 1
[�Residential ❑Commercia)(Approval Kequired}
❑iVew ❑Additional ❑Repairs (�Replace
Job Site/Owner Information:
Site Address: ?i3Q� �RySTAL F�Y RL1AU-WA�1�_.�CTR.�� 55?�91
Owner:W1LLIAM 1ti10t_�SUL� Mailing Address: �IO NOCtT��,��,.� RD
c�cy: �,�1Av�A�t"A z��: �"'a 3q t
Home Phone:���1� , '(.D�a�J Alternate Phone:
Contractor Information:
Contractor: �PGTICAL SySTEMSContact Person: S�RRI� ���'AD
Address: �3���C�K R�State Bond#:
City: ��Pk.l�S Zip:S��-{3 Expirarion Date:
Phone: Cq5Z�q33-la(o8 . (952) Q33' 18(flq
Fr�x:
❑ Insurance—C`urrent:
1
9529331869 13:36-42 03 12 2015 2/3
;. MECHANICAL SYSTEIvIS BEING INSTALLED
Note:Alt GeothermaI Syste�ns will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes [�No
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTtJs:
Output BTUs:
CFM:
COOLING SYSTEMS
Qaantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
[� Gas Factory Fireplace Brand Name: �,/�V�S
❑ Wood Burning Fireplace
❑ Wood Stove Model No.: QS5�4 t�i3
❑ Wood Stove with Flue/Masonry
VENTILATIOAI
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FCJEL STORAGE (Mtrst be approved by Fire Marsha/l if proposing to obando�:tank i�t placc:)
❑ Insta{lation ❑ Ttemoval
Fuet Oit: gaqo�s ❑ Underground ❑Inside ❑Outside
LP Gas: gaElons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
y9529331869 13:36:54 03-12-2015 3/3
< PERMIT FEE CALCULr�#TION(S)
BASED OEF-2002 STATE-STATUE `
❑ Yes,this section applies
The replacement of a Residential fixtwe or ap�liance that meets all three of the following requirements:
1. Does not require modification to electricai or gas service.
2. Has a t 1 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 5urcharge $ 5.o0
Mail-In Fee(If Applicable) $ 2.0
Total Permit Fee $
PERMIT FEE CALCULATION S -JOBS OVER'$500.00
If above does noi apply;follow guidelines below:
1. CONTRA.CT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
(�2�JVIJ•W x.0125$ �Q.Vt1
(contract pricc) (min3mum$50.00)
2. STATE SURCHARGE
�Z� 'rJ�•Q7 x.0005 I•Z
{contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines I-3 Above) $� S!. Z.�j
■ * CONTRACI' 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. Tf any material,eyuipment,labor or installations are furnished by
the owner,tenant or any other party,the reasonabfe mazket value of such items must be added to the
estimated cost or contract price for permit fee purposes. Tn the event that there is a dispute on the
amount of the job cost, the Ciry may request the submission of a signed copy of the actuai contract.
1VIECHAIVICAL PERIVIIT 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
Mi�uiesota, and certifies that all statements made on this application are complete, true and
correct.
Applicant's Signatur : a- C G!� Date: � �2 �S
3
�
DATE T
CITY OF ORONO cnLLED IN ' �
INSPECTIO OTICE �S SCHEDULED L�����
PERMR NO. ��'� COMPLEfED �_
ADDRESS 33QQ t� �O�'� �
OWNER TEL PHONE NO.��� ' �� ���
CONTRACTOR
� DESCRIPTION r
4~j ❑ FOOTING ❑ DEM INAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
c�i, COMMENTS:
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� �SATISFACTORY:PROCEED ❑PROJECT COMPLETE
W ❑CORRECT WORK�PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
�CORRECTUNSAFECONDITIONWITHIN HOURS. ❑pHOTOTAKEN
INSPECTOR WFIL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cal1 for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector: � �^^�
Whits CopyAnapector's File Cenary CopylSite Notke
�� DATE TIME�
CITY OF ORONO CALLED IN 3�� �a '�'�'
INSPECTION NOTIC� SCHEDULED 3 a Co \a�
PERMIT NO. aU\5 -��aq�COMPLETED
ADDRESS �3� � �T� � � '
� �
OWNER ��� TELEPHON`N . � a ���
CONTRACTOR �'K''�'��'�-�- � � S'e-�c- �
� DESCRIPTION
W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB �Jv1ECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAI ❑ WATER HOOK-UP ❑ FOLLOW-UP
41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOR T EET YOU•_YES_NO
v�i COMMENTS: �0.S �� � `�
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W RK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
� CO ECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR W{LL RETURN
❑STOP ORDEH POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hou in advance. �9 -46��
OwnerlContractor on site: �
Inspector. �
White Copyllnspector's File Canary CopylSite Notice
� � � DATE � TIMLL'/
CITY OF ORONO CALLED IN ;6 -�— /-5
INSPECTION N T �`;�XscHEDULED �O� �
PERMIT NO. 1�+ '�J PLETED
ADDRESS
OWNER � EP ONE NO. �
CONTRACTO
.
� DESCRIPTION
W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVEfi REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERICONTAACTOR TO MEET Y�OU:_YES_NO
��., COMMENTS:
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W O WORKSATISFACTORY:PROCEED P JECT COMPLETE
� ❑CORRECT VYORK 8 PROCEED UE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WRHIN HOURS. ❑pHOTO TAKEN
INSPECTOR WILL REfURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION RE(]UIRED.CALL TO ARRANGE ACCESS.
Ca��forthe next inspection a tw • a �(952) 249-4600
OwnedContractor on site:
Inspector:
J
White Copyllnspector's File Canary CopylSRa Noties