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Permits - Permit# 03-16M - 2401 Black Lake Road - 1/1/2003per- 16 -;, 47/�/d�3 CITY OF SPRING PARK 4349 WARREN AVENUE SpmG PARK, MPMSOTA 55384 952-471-9051 APPLICATION FOR MECHANICAL PERMIT' 1. You may apply for niecbanteal 11e9101ts by mail Or Is perea® at tbo City 0Mcce. Appficalioes will be reviewed and a permit will be issued within 2 working dare. 2. Permit cards will be sent by retora snail after a review is completed. PERMITS ARE NOT VALID LINTEL YOU RECEIVE A PERIMIIT, 3. MtichabkW..kgjp! - Complete calculations, details and rpechleaiions are required for each heating, ventilation, bnanidificatlon-debunddilleatlon, and air cveditloafnR Installation including bait low/beat gain calculation, deelp temperoures, equipment ratings and idendlicatioa as to tree, mnaulactwer and model. Data shall be presented on form provided. Identification of and gimilleations for water heatfug equipment shall ale be provided. 4L When any new construction or remodeft is involved, a separate building permit mast be obtained. 5. AD work must be done in aeeardeste with the Uniform Mecbaeteal Code/State Building Code rogidrenteals. & AO wwk must be latWKbd {roal" and final} Can "2-2a-a o. A 24 boar notice is required. 7. Rom Heating Test Record mast be mbmiKed before Anal. 114MICTIO" Complete afl items on this application Compute the permit fee. Sign wed date the eerdfit edom INCOMFUNZ APPLICATIONS WILL NOT BE PROCKSSED. N you have questions, call 952-249-AW or 952-471-901. Please cbeck one: New -XI, Addition Repair Replace Aesldentitil , -le Cosa amw JOB srrla / �/ J� L�.�"L S r owner's Name MaNn Address _ Contracine's Name Matling Address ✓t ,77 Number (- / a_ EMATV41G SYSTEMS Quantity '�— Make Model Gs IM o lhsel G n0 Inve Sin UVA BTUs 0 1z,d Output BTUs eo �— CFM._ COOLING SYST130 �— MKim .� --- Moab Taws B. Power --�— d o 195Zti 1109 'ON/00: S 'iS/ N: S l NN 0 l 6 i031,' �aVd DN I ddS dC hi I O NOdd hiechaniekl Permit WOOD BURNING EQIINI' Woad stave with no WOW combination or add -on Factory fireplace with flue Factory lirepiace(s) Freestanding Wood Stove (s) Franklin, other Brand name m(gr•s Min., Clearances, side rear Vi ,A 'a r r _ Model No flue dla. Total No. Kitchen exhaust - dotted rWnWadn elm No. �.— Bath esAaust mast be eted ou Ids dko / No. „- _ Other %ns: Loeations h��v%s )D�en.�Cn tfm o Total FEEL STORAGE (MUST BE APPROVED BY ME MARSHALL) 101"Hadon Regal -W Fuel Oil XdIM . underground inside outside LP Gas galkons Other Sm opening — vsr>earrr t1SE ICALCMrTldm 2Jkll State 9tatnte Yes, This Seetion Applies The replacement of a that meets all three of the foil mbl requiremento: 1) k2aLllllit require medWiication to electrical or got service. 2) Has a tafk.Sd9t of L%ftoo or less Bijtdlftg the coat of the f xtere or appliance; and 3) Is improved, installed or replaced by the homeowner or licensed contractor. Skip nest section; Cost of Permit S 400 State SemchWW S _so bw In Fee S LW- 1. 1.23% of Cmdr2d Price r or MiWMEMF®e (;�OO) 1 UO (Contract Price) 2. gtatftteh " Add the State Bnitding Code Division Sorc harge to each penult. Zvi (Contract Price) er S.SO, whichever U greater 3, (Only mail -in appikdkons) S 4. TOTAL PERMIT FEE (Add Ines 1-3 above) S,_ " CONTRACT PRICE or JOB COST means the actual or eatlasated dollar amount charged for the permitted work including materials' labor, profit, and other Rued costa. It is the amount to be charged to the e®stom@r for the work dose. Many materl* equipment, labor, or laatailation are fnrniaked by the ounw, tenant, or any other party, the reamnable market value of sash items amot be added to the estlmatei cost or contmet price for permk fee purposes. In the event there Is a dfspade osa the anaMt 8 d l9SLt l l.0S 'ON/00: S t 'iVN: S l "N0Z 0l. 6 (03A) ''bvd IVIIN i HS J0 All O WOEd Moohaaical Permit of the job cost, the City may regaeet the sabmissloo of a sigma eon of the actmd contract. ** The STATE SURCHARGE is .OM of the contract price under $1,000,000 or 5.60, whichever is ®renter. For valuations over $1,000,00o taU the Department of laspectlonai Services for the i The uunderdgned hereby applies to the City for hu mee of a Mechanical Permit, agrees to do all work in strict accordance wlih the ordinances of the City and the regulations of the Minassots Stab Hmlding Code, and certifies emenis njib os this appWaden are complete, true and eorreet. Applicant's Approv" BY 3 b d cl?S'It !l09'ON/00:G�'iSio0:cl S00d 0l 6 (01A) �d 9NIddS d0 1i!O NOda