HomeMy WebLinkAbout2018-00144 - gas fireplace � ' CITY OF ORONO
2750 KELLEY PARKWAY * 2 QJ 1 8 - 0 0 1 4 4 *
DATE ISSUED: 02/12/2018
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 1150 PINE VIEW DR
PIN : 28-118-23-42-0009
LEGAL DESC : PINE VIEW
: LOT 3 BLOCK 1
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 6,000.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
(1)GAS TO WN AND�OUNTRY 42
(1)GAS MONTIGO H'SERIES
(1)WOOD ORACLE 42"
APPLICANT MECHANICAL 75.00
STATE SURCHARGE MECH(VALUATION) 3.00
TWIN CITY FIREPLACE STONE CO INC MAIL-IN FEE 2.00
6521 CECILIA CIR
EDINA,MN 55439- TOTAL 80.00
(952)777-4125 Payment(s)
Minnesota State License#:mech-MB682977 CHECK 22893 80.00
OWNER
WOHLWEND,DAVID
4526 BLUEBELL TRAIL S
MEDINA,MN 55340-
AGREEMENT AND SWORN 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 Buiiding Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whe�t►er or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 da s of the date of issuance,or if construction is
suspended for a period of I 0 days at any time after work has commenced.
The applicant is responsibl for assuring all required inspections are
requested in conformance ith the State Building Code.This permit may be
revoked at any time for du cause.
t7°lC�{�� .�/L � � IoZ � ��
Applicant Permitee Sign�ture Date Issue By Signature Date
FOR CITY USE ONLY
O City of Orono
� �O P.O.Box 66 Date Receivedi�-�Permit#��j_c�
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By: ��" Amount$:�
Phone(952)249-4600 Fa�c(952)249-4616
�� �
`�'�fSH���` CITY OF ORONO—MECHANICAL PERMIT
(All Commerciai permits must be approved by the Building Official or Inspector and/or Fire Marshall)
ENERAL INFORM.�TTt3N
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 Desig`ns—Comp(ete 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
I 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.
(2448 hour notice required)
7. House Heating Test Record must be submitted before final.
T��oF PEx�T
Check All That A 1
I�Residential ❑Commercial(Approval Required) [Backflow Device: 0 AVB ❑PVB]
i� New ❑Additional ❑Repairs ❑Replace
Job Site/Qwner Information:
1150 Pineview Drive
�ite Address:
Owner:�a��d s M� �Jo�.l W� Mailing Address:
�ity: Zip:
�-Iome Phone: Alternate Phone:
I Contractor Information.'
Twin City Fireplace and Stone Brenna Kelly-Starkebaum
Contractor: Contact Person:
6521 Cealia Cirde
�ddress: State Bond#:
y,l�. Edina Zip: 5•`�39 Expiration Date:
1`
952-777-4725
�'hone: Alternate Phone:
' ❑ Insurance—Current:
1
• � i
Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official.
I3 THIS GEOTHERMAL? ❑Yes �No
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
�lue Size:
iinput BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
�Make:
�Model:
!Tons:
H.Power
�'IItEPLACES (gas)Town and country 42
(wood)Orade 42"
0 Gas Factory Fireplace 'Q Brand Name: (gas)Montigo H series
� Wood Burning Fireplace
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry
ENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath E�chaust(must have duct outside) cfin
� ❑ No. Other Fans: Locations cfin
,�'[JEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in p/ac�)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
i 2
PERMIT FEE CALCULATIONS
1. CONTRACT PRICE * is I.25%of contract price with a(Minimum Fee of$50.00)
6000.00 75.00
x.0125 $
(conhact price) (minimum$50.00)
2. STATE SURCHARGE 6000.00 3
x.0005 $
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
80.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
• * CONTRACT 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. If any material,equipment,labor or installations are furnished by the
owner, tenant or any other parly, 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.
MECHANICAL PERMIT APPLICATION AGREEMENT
The undersigned hereby applies to the City for issua e of a Mechanical Permit, agrees to do all
work in strict accordance with the o in es e City and the regulations of the State of
Minnesota,and certifie t all state nt a is application are complete,true and correct.
1/26/18
Applicant's Signatur . Date:
3