HomeMy WebLinkAbout2005-P09003 - air conditioning . ` PERMIT
CITY OF ORONO Permit ►vumber:
2750 Kelley Parkway- PO Box 66 P09003
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Pernuts
(952)249-4600 Date Issued: 7/26/2005
SITE ADDRESS: 2655 Pheasant Rd Unit#
Excelsior,MN 55331
P��� 21-117-23-23-0005
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Pernut Type: Mechanical Pernuts Permit Sub-type(s): Air Condirioning
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 100.00 valuation: $ 8,000.00
State Surcharge Fee: $ 4.00
TOTAL FEE: $ 104.00
APPLICANT: Countryside Heating&Cooling OWNER: James&Cheryl Johnson
6511 Hwy 12 2655 Pheasant Rd
Maple Plain,MN 55359 Excelsior,MN 55331
THE UNDERSIGNED HEREBY REQUESTS 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.
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APPLICANT P$RMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(SignaturesRequired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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FOR CITY USE ONLY
City of Orono
���� �'' P.O.Box 66 Date Received: Permit#
`���a , Q�` 2750 Kelley Parkway
� ���� �;,' Crystal Bay,MN 55323 Approved By: Amount$: ��
� � �{ Y�t;;� (952)249-4600 ���
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CITY OF ORONO-MECHANICAL PERMIT `��
(All Commercial pennits must be approved by the Quilding 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 Desi�ns—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.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
(Check All That A 1 )
❑ Residential ❑ Commercial(Approval Required)
❑ New ❑ Additional ❑ Repairs � Replace
Job Site/Owner Information:
Site Address: �_p�� �� �hE�c+�.���► �� ��
Owner: ��;n1 �- ��Ft H� �����S��t Mailing Address: ��jS f�hE't Su-��t r� �
City: �%it;•1� Zip:
Home Phone: �.�,�- �I� I-l�°�� Alternate Phone:
Contractor Information:
Contractor: ��xti �� �tk �(.CY���►�� Contact Person:
Address: ��j � � E�w•� )� State Bond #: � � � ��'� 7 ���
City: � � Zip:� Expiration Date:
Phone: ?63���1-1 bU� Alternate Phone:
❑ Insurance-Current:
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� � MECHANICAL SYSTEMS BEING��INSTALLED � ��
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity: !
Make: a���
Model: �7���'L y
Tons: 3 a ��
H.Power
FIREPLACES
❑ Gas Factory Fireplace
❑ Wood Burning Fireplace
❑ Wood Stove
❑ Wood Stove With Flue
Brand Name: Model No.:
VENTILATION
❑ Na Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
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PERMI"I" FEF. CALCULA�I,ION(�S) �
� � BASED OFF - 2002 STATE S�I'A�I,UE � �� ���
❑ 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;excludin�the cost of the fixture or appliance: and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section, ifthis applies; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee([f Applicable) $ 1.50 �
Total Permit Fee $
� � � � PERMIT��FEE CALCULATION(S —JOBS OVER$SOff.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)
�fi'c�•��% X .o�2s $ /Dd� ab
(contract price) (minimum$35.00)
2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fce of�.50)
g Jv 4?��� X.000s � �. ��
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) � �" L�Q�
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitCed 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 tlle price.
MECHANICAL 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.
�
Applicant's Signature: Date: �—����
' Reset Form
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Building Codes and Standard Division
Commissioner of Labor and Industry
Has Received and Filed a $25,000 Surety Bond,
As Required by MS 326.992, for Work Regulated
_ by the State Mechanical Code
To: Crai�Schumacher Bond No: 55-191407
Countryside Heating&Cooling MB ID: 00220
, 6511 Hi�hway 12
Maple Plain MN 55359
Effective Date Expiration Date
7/1/2005 6/30/2006