HomeMy WebLinkAbout2018-00477 - mechanical � ' CITY OF ORONO * 2 0 1 8 — rd 0 4 7 7 *
2750 KELLEY PARKWAY DATE ISSUED: 04/18/2018
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 680 PINEHURST CT
PIN : 06-117-23-33-0015
LEGAL DESC : LAKEVIEW OF ORONO
: LOT 16 BLOCK 1
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 9,880.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
INSTALL GAS FIREPLACE-HHT MODEL PRIMO 48ST
APPLICANT MECHANICAL 123.50
FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 4.94
2700 FAIRVIEW AVE MAIL-IN FEE 2.00
ROSEVILLE,MN 55113 TOTAL 130.44
(651)633-2561 Payment(s)
Minnesota State License#:mech-20512060 CREDIT CARD 4616 130.44
OWNER
MOLINE,JEFF&KARA
620 PINEHURST CT
MOUND,MN 55364-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable Ciry approvals,and the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specifiad 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 confortnance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Issu d Signature te
04-18-'18 13:39 FROM- T-811 P0001/0004 F-289
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��^ CiC•of Orono ` 4,7' i
P.0 Ba�c G6 qatc 2c�cc-a�:� Pcl'tni��' � �
� 3750 Kellcy E'ark�sa�•
Crt•stsi Ba�•,AI�S33$3 Appmve Hy., n�inun!S;��. �
Phon�(9S�)za9-�600 fn�(953�3d9.a616 �
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���M�sHo��G CITY OF OltOt�O—M�CHANICAL pERYIIT �
(�ll Cou�mr���pMalils m��sr ik appros•cd by iha Bi�i�ding�(lirbl or lnspeceor and/ar Fira�1Esrshatl) �
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CrEN'�RAL,INFORMATiON ;
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l. Yau may a�ply for mcchanical pc��niits by�m811 Or in Pcrson at tlie Cih-of(iccs. Appiications wil[ �
be revicu�ecl and�permit will be issuecl�viEGin two�vor(:ing days. #
2. Permit cAecls�viQ be se+�E by rztuitit mail Aftcr a revie�r•is compleird. PER14t[T$�1RE Np7 ,
VALID UNT1L YQU RECEIVE A PER1vIIT, �'VORIG�IUST lOT I3�CIN U\'T1L TFIC �
PERbI1T C�r�YtD[S POSTEn OrI'K'k;(�,1pB SITE. +
_ 3, htechanical Desians--Complete eaJeulatio�ls,cletails�iid specificetians are reqt:ireH for eacli �
heating,ventilation,humidifieation-dthumi�li�cation,and eir conditionin;instaUadai ineludi»a �
iieTt loss/heA�g��n C21Ct�latioit,design tcmperafures,ec�uip�ttent ra�ings Rr�!identific�lioit es to +
type;mauufacturcr a�id mociel, 17aEa shTl!be presented on fotm provided. ;
�4. LYlzen any neev coustruction or remodeling is involved,a separ�te b�iildins pernut must be i
obt�ined. � �
3, AU work m�ist be do�re in accordance�vidi tlie Uniform I�lcehsu�ieal CoddSt�l�Building Codc �
requirements. �
G. Atl�vork ntust be iaspectetl(rou�h-in and fc��al). Cnli(952)2��-a60D. �
(Za-a8 hournotire required)
7. }-Cousc E{eatiuo Test T.ecord must be se�bmitt'rd before finn(. {
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TYC��0�'PERMiT
� (Check All Th�t A 1 -)
�Resident«1 ❑Con�nleYCiftl(Appro've1 Rec�uired) ;
�New ❑Adt�i#ianal [1.Rep,�ira �R.eplgcc ;
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Job Site/Otiwier Inforn�ation: '
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Site Addr�ss: '
Owner: /I�a 0� �`_,OM�,� tvtailingA.ddr�ss: ��ZI���tL�'/�%GN �✓ i
City: 4� Zip: � ;
Hoiiizv�onec� � � ~ �� Alte�'nflte Phone: �
Contr�cror Infon�fltion:
Contr�ctor: F1RESfQE HEARTH& H�M� Cuntt�ct Pe�-son: ����'�
Adch-css: 2700�airview Ave N State Boitd#:8C662S56,M�652572, PC662571
City: Rosevilfe, MN �i�55113 E�piratio►i Dt�te:
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Phone: 65i-(2��-'�S�W Alternate Phone: lr'����3��'.�31�
❑ Insuranee—Cin•rent: !
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04-18—'18 13:39 FROM— T-811 P0002/0044 F-289
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MECHAN�CAL S�t'STEMS B�TNG TNSTAI,�,El7 �
Note: All Geotl�erm�t Systems t�•ill np�v requa��e a Site C'lan��C Review by oiu•BL�ildin�Qf�icill, i
!S THIS CEOTHER1�lA1.? ❑Yes ❑No '
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x�arr�c ss�sr�c�rs �
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�roctel: �
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Fucl: �
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Flue Siae;
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Input BTUs: �
Output�TUs: f
CF�,(: f
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COOLING Sti'STE�IS j
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Qtlantity:
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R�f�kc: �
�fodel:
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Tons:
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FI_Pouer ,
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�'lREPLAGES ��cSf'���� �/�'�'�- �
� Oas Factory Fireplace Br�nd 1Vame: �ff � ,
1Vo�d$utning FireplTcc �
❑ tiVood Stove tVfodel No.: � I'd)
❑ ��Vaod Stove�viil�Flue/Nlasonry
��Etir��,:��-�o� �
❑ t�b. tCitcl�en Esh�ust duct i�;ircal�tin� c5n
� h'o. Bath L��h�ust(must ha�•e duct outside) cfiu
❑ \�a Other Fans: Locsdions cfm
PL�EL STOR,�GF. (,{lir.sl bc n�>pru��ed h��Fire r�la�s/rnll lf p�•nposiirg to nb�rn�lo�rtrrnk in pl��er.)
. [� IRSIAII£1LI011 [] Fcmovnl
Fuel OiL aatlo��s ❑ [Jnder�round ❑I»Si<te ❑Qutside
LP Gas: . ;allons
Othzr:
C�S L(\E O�`Ll' �
n Outdoor Grill � Other I C.is�1�,'Etnt��Vliere� '
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04-18—'18 13:39 FROM— T-811 P0003/0004 F-289
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PERMIT PEE CALCULATION(S) ;
BASED�PF-2002 STAT�STATUE '
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❑ Yes,this Section t+p��lies i
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The repinctmenr of,t Residentixl Fxture,or apJ7liaqce th�r meels All lhree oFtl�Follo��ri�ig rcquiremti�ts: �
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t. 1'?�es not�eyuirr uiodificafion to clectrical ar gas service. E
2. �ies R I cost of$300.00 or less;excludin2 tlte cost of the fixtn��or appliAneer aEtd �
3, is improved,installtd or rcplaced by d�e lioiuea�vitei•or licensed conU�ctor. �
Skip nest section,if d�is eppli�s; Cost of Aennit $ I5.00 �
$tAtC SUTCI18C�6 S S.QO �
Mail•In Fee(if Applicable) � ___?•09 �
Total Periilil Fee S (
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pERMIT PEE CA,�.CULATION(S)—�O�S OVE�$500.00 ;
!
If above does not npply;follow giiicleli�las belp��: �
L CO�TRA.GT PR10E x is I?5%of c%� pxicc�vith a(lfinimurn ree of 350AD�� �
�6 �' Z3 �� '
X.�ias s j
(toolfBC�ptfCtl)' (mininikni S30.00) !
?. ST,�iTCSURCEtr1RGE �� � g'�'I ;
x AOOS S �^ ;
`(coni?nct price)
3, POSTAGE R 1•IA\DL)�1G(Ouly on\I�il•In Applicntions) $. -2.OQ . f
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�4. TOTr�,L PGR111T P��(Add Lines !-3 Above) ��Qfr� �
■ "" COVTI�ACT PRICE or JOS COST iuenns the �cni�l or estimttt�d dollnr amau�t chnrged For tlu ,
p:rt)lilted�+•Ork iqClu�ling mNltrials,Inbor.pivfit,anc!otiier Fsed costs. (�is the amoimt to be ch8rgecl
ro the custonur for lhc�►•ork done. ff an�•inateriaL cqulpment, tabor or inst�ll�tions flr�furuishecJ by'
tlte onver,tcnnn[or nny ather pnrty,the reasonablc ntarket��11cie of Sueh itemS rnuSt be Ac�CIcQ (o thc ;
eslimaled cost or contract price for pern,it fee Nmposes. In tI1Z CVC06 tIllLf II1G'C IS R CI15pllIB 031 II1L .
amount oF the job cost, tl�e City„�fly rtq�tcsc tlie subtnission of a signed cop�•pf the�ciuni contract. �
MEC,f-TANICAL C'�RMTT?�1��'LIC�ITION AG2EEMENT .
The undaesigned hereby ap�lies to Uie City fvr issunnec of� �techanical Per���it, flgrees to do all �
tYork ii� stE•ict �cca•dance with the orciiilnnees of tI�e City �nd t>>e regularions of tl�c Sk1te oF
Nlinnesotn, anci etrtifes th�t all st�tements m�cle oi� this application �re eo�nplete. u•ue �nd
correct.
Applic�nPs Si�nature: �`� Date; �
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