Permits - Permit# 03-22M - 3826 Budd Lane - 1/1/2003OCT-27-2003 14:39 MORTENSON 7632875581 P.02
3
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CITY OF SPRING PARK
4349 WARREN AVENUE
SPRING PARK, MINNESOTA 55394
952-471-"51
APPLICATION FOR MECHANICAL PERbDT
1. You mqy apply for met6anlcal permits by mail or in person at the City oBices. Applications will be
reviewed and a permit will be iaasued within 2 working d1arL
2. Permit cards will be sent by retyrn dnali alter a review is completed. PERMUS ARE NOT VALID
UNTIL. YOU RECEIVE A PERMIT,
3• - Complete cmlculadons, details and mpecificadonb arc required for cub
h(satlgg, veoabfaablon, humidificatloo-debu ildifleation, and air cond1donin6 installation Including hear
loaaalbeat gain caleul;clog design temperatyres, equipment rntimp and idcatwGeatim as to type,
manufacturer and model. Doty shall be presented on form provided. identification, of mod
Specifications for water heating equipment shall also be provided.
4. When any new construction or remodeling Is Lavolved, a Separatr building permit mast be obtnineal. S. AD work must be done In accordance with the Uniform Mechanical CodwState Buditg Code
requirements.
6. All work mwt be Inspected (rough-lo dad anal). Call 952-249-4600. A 24 hour notice Is required.
7. Bowe ,Heating Test Record must be subvn&W before dog.
Complete all items on this application. Compute the permit fed Sign �d date the
certification. MCOMPLETE APPLICATIONS WILL NOT HE PROCESSED. N you have questions,
CAA 952-249-&M or M-471-9051. _
JOB SITE ,K
Owner's NameU L
Mang Address a Number - �s
W
Contractor's Name 3�
Malling Address --- Phone Number
SEATING SYSTEMS
Quabtlb /
Make _
Model L 619�
Fuel p�5
Flue Size
Input BTUs D �--
ov<p„t---
CFM
COOLING SYSTEMS
Quantity
Make --
Model — �—
Tona
B. Power
Please check one: New ` addition Repdr Replmce ✓
Residential ✓ Commercial
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1
OCT-27-2003 14:40 MORTENSON
7632875581 P.03
Merbaniml permit
WOOD BURMG EQUIPMENT
Wood slave with five
Wood combination or add-,aA
Factory fireplace with fine —~
Factory fireplace($)! >mae ding
Wood Stove (s) M"Onry
blraokllq other Brand �^--
name
Mrgr's MIA., Clearatxes, side Model No
.�— rear. ndL flue dIL
Told
VENTILATION
No. �- Mtchea exhaust - ducted No. �reclo<culatiqr,�
Bath e:hamt (mttyt be ducted outdde) chn ~�
No. Other fats. Location!
dm��
Total
FUEL STORAGE (MUST REAPPROVED BY FIRE MARSIEAL )
Installadoe Removal
Fuel Oil galloon wodergrotmd inside
LF Gas gallons outride
Other
gat opening
Yes, T116 Section Applies
The replacement of R*PPI12neethat iumb all throe of the follow* requirement,:
1) DINs require modification to electrical or gas ""let
2) n" a121&LOUof 5300.00 or leas
3) Ia improved, installed or replaced by theowq or licensed conte cost of the rizinre, or rapctoar. ec; and
Skip next aecoom; Cost of Permit S
State Swebarge S
Moil In Fee S -
L IJ5% of • or
e 1.0125 f
(Contract Price)
2. •. Add the State BMildigg Code DMvion
Surcharge to each permit: � I.Ow $ •
o 5.50 Ichever is !realer (Contract Price)
3' (Only mail-iu applications)
4. TOTAL PERhQT FEE (Add lines 1 3 above) t]���j�
CONTRACT PRICE ur JOB COST mesas the actual or estimated doll
permitted work including materials, labort charged for the
Profit, �wd other fixed costa. It is
to the cWtolller for the work dope_ 1f my material, equipment, labor, or 1034lliitioo are firrnlaped by
the owner, tenaot, of any other party, the reasonable. market value of such items must be added to the
estimated coat or contract price for permit fee purposes. In the event there h a dispute an the atsomt
d L�95lelI0S'ONibi:8 Itii/�':A cnn? 77 n,
Mcehaaiw PcMak
of the job cost, the City Msy request the =bn6ssion of a dgaed copy of the aetnal enntMct.
The STATE SURCMAR(;E Is .OW of the coDiract price under $1,000,000 or &SO, whichever is
gre%ter. For valaatioDa over $1,000,000 call the Department of laspeedoaa! Services for the
price.
The undersigned bereby applies to the City for issuance of a Meehaaical permit; apses to do all work
I4 strict accordance with the ordinances of the City sad the regulndons of the Mlnaesotx State Huilding
Code, and cerdCea that allp temeD f oh this application are complete, true and correct:
Applicant's Signature
Approved
City acknowledges herewith receipt of $37.00 and grants the replacement of existing
furnace with a used furnace to provide temporary heat only with the following conditions:
By so granting, the City neither expresses nor implies that:
A) The existing non -conforming structure is safe, secure or fit for occupancy;
or that
B) The existing non -conforming structure may be changed, altered or
improved.