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CITY OF ORONO * 2 0 1 7 - 0 1 0 8 2 *
2750 KELLEY PARKWAY DATE ISSUED: 09/07/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 530 SANDHILL DR
PIN : 33-118-23-24-0020
LEGAL DESC : ORONO PRESERVE
: LOT 1 BLOCK 2
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 3,026.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
HHT GAS FIREPLACE
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.51
FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00
2700 FAIRVIEW AVE
ROSEVILLE,MN 55113 TOTAL 53.51
(651)633-2561 Payment(s)
Minnesota State License#:mech-20512060 CREDIT CARD 4616 53.51
OWNER
OPS Orono LLC
15250 WAYZATA BLVD#101
WAYZATA,MN 55391-
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 Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires separate
permiu. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction suthorized 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 conformance with the State Building Code.This pertnit may be
revoked at any time for due cause. '
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`� � 7 �/ �
Applicant e itee Signature Date Issued B ignature Date
, 49-�7-'17 09:45 FROM- T-756 P0001/0004 F-106
3g��(�b�j — d�os
o� r��s�o�►��
,�� City of Orono �p�-� /6��
P.O.Box 66 Date Re e� Pormit�
� 2754 Kelley Parkway
GYystal Bay.MN 55323 APProved By: Amount S:
Phone(952)249•4600 Fax(952)249-4616
� �`��.� ��.��� CYTY OF ORONQ--MECHAMCAL PERMIT
'� S H O (AI!Commercial p«mirs must be approvcd by the�uilding OtFicial or Inspector andlor Fae Marsha�l)
GEN�ItAL TN'�OR1I�ATXON
1. You may apply for mechanical permits by mail or in,person at thc Ciry offices. Applications will
be rt'vitwed and a permit will be issued within two working days.
2. permit cards will be sent by retum mail after a review is completed. PE�MTTS Alt$N'OT
�'AY,Yb C.1'NTIL YOl1 RECEIVE A PERMIT. WORK MUST IYOT�EGCN C1N�'XT�1'�
P�RMY'T CARb YS POSTED ON THE JOB SITE.
3. Meehanrea�17esiQns—Complzte ealeutations,dctails and specifications are required for each
heating,ventilation,humidiftcation-dehumidification,and air eonditioning installation including
heat loss/heat gain calculation,design temperatures,equipment rbdngs and idtntification as to
type,manufacturer and modei. Data shall be present�d on form provided.
�. When any new construction or remodeling is involved,a separate bu'llding permit must be
obtained.
5. All work must be done in aceordanee with the Uniform Mechanical Code/State�uilding Code `
requiremants.
6. A.II work must be inspected(rough-in and final). Call(952)249-4600.
(24-48 hour notice required)
7_ House�Xeating Test Record must be submitted before final.
TYPE OF PERMIT �
(Check All That Apply)
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rob Site/Owner Information: �
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�om �`"`�'�; i j1�� ��J"�����Alterr►ate Phone:
Contractor Information:
Contractor: FIR�SID�H�ARTH & HOME �ontact Person: I��`'r�"'�
Address: 2700 Fairview Ave N State$ond#:BC662656,MB662572, PC662571
City: Roseville,MN zip;55113 gXp;�tion bate:
phone: 651�33-2561 A[te��nate�'hone: �U `!�3 0��""
❑ Insurance-Current:
1
, 09-07-'17 09:45 FROM- T-756 P0002/0404 F-106
.. .
': . ' :.:... .. :. ..: ..` ��':�:1VIEC�NICA�.;�S`Y'S'T�,IV�S BE�Cr.�TSTA�:ED<'.::,::,...`. ..: :.' .'. ,:�.;::.;�
� Note:All Geothermal Systems will now reqtzire a Site plan Bc lteview by our�uilding Official.
YS THYS GEOTHERMAL? ❑Yes ❑No
HEATING SYSTEMS •
QuantiCy:
Make:
Modei:
Fucl:
�'lue Size:
Ynput B7'Us:
4utput B'P[.Ts:
CFM�
COOLING SYST�MS
Quantiry:
Nlake:
Model�
Tons:
H.Po�wer
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t .� ,��� �. •Y,
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'�'�;N'fY�,AT10N
❑ No_ Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ N'o. Other�'ans: Locations cfm
F�EY.STORAG� (1►�i�st be approved by,i�Yre Marsha!!if proposi,rg to nba�id'on ta:tk in place.)
❑ Installation ❑ Removal
fiuel Oi1: gallons ❑ Undet�round (]Xnside ❑Outside
�.P(3as: gallons
Other:
GA,S X�MN�ONLY
❑ Outdoor C�rilt ❑ Other/I.ist'VVhat&'41r'here:
�
. 09-07—'17 09:45 FROM— T-756 P0003/0004 F-106
� . .. �.. PERMIT.FEE CALGUr,ATION(S) : .: ..:� � : ,. .
BASED OFF=.ZU02 STATE STATUE. .��. �:� :` . . .: �
Q 'Yes,this section applits
The replacemcnt of a Residential fixture or appliance that meets all three of the following requirements:
l. boes not t'equ�'e modification to eiectrical or gas service.
2. Has a total cost of$500.00 or less;excludin thc cost of the fixture or appliance:and
3. Is improved,installed or replaecd by the homeo�wner or licensed contractor_
Skip next scction,if this appiies; Cost of l�erm'rt $ 15.00
State Surcharge $ 5.00
MaiI-In Fee(If Applicable) $ 2.00
'X'otal�ermit Fee S
:, P��MT�F�CAL�C]ri.;ATYON(S)'�JOBS�OVER$500.00 .,` .�.;.:
Tf above does not apply;fpllow guidclines bclow:
1. CONTRACT PRICE '"is 1.25%o contract pricz�+vith a(1V�inimum Fee of$50.00)
�� /�` ""��."..,,,-'-,- -�:��,�
'rH 1��..�`':;4';'•.`,i''T.�i�!�3.�;�"v.':i:s��"�"�"1;:�;.-.�
��'t01.'t�I�t�k � `p1j11��1�!.�.'L•...�V
2_ STATE SCJRC�TARCx� 5 ��(� j �(
�.' .'�
x�OQ05.�'._$� l -
3. POS7'AGE&HANDLING(Only on M&il-1n Applications) O__.� �'��
i•?..�,:.,
4. TOTAL PERMIT�'E�(Add L'rnes 1-3 Above) ��-Tr�:.�'� ' �`:'�`��
■ * CON'TRACT p�iTCB or 70B COST means the actual or estimated dollar arnount charged for the
permitted work includin�materials,labor,profit,and other fisced casts. Tt is the amount to be charged
to tfte customzr for the work donc. If aE�y matcrial,equipment,labor or installat�ons are furnished by
the owner.tenant or any other parCy,tht reasonable marl�et'value of such items must be addcd to the
estimated cost or contraet price for permit fee purposes. Yn the event that there is a disputo on Che
amount of tho job east,the Ciry may request the submission of a signed copy of thc aetuai eontraet.
MEGHAIVICAL PERMIT APPLICATION.A:CxR,E�1VIENT ,
The undersigned hereby applies to the City for issuance of a Mechanical Permit,agrees to do ail
work in strict accordance with the ordinances of t City and the regulations of the State of
Minnesota, and certifies that all statements ma on this application are complete, true and
correct.
Applicant's Signature: �te:: ��_� I
3
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DAT/ TI E
CITY OF ORONO CA ED IN
INSPECTION. OT�E�i��- CHEDULED � //.' D7�
PERMIT N � COMPLETE�
ADDRESS ��� �1�����' ���
OWNER TELEPHONE NO.�� � �S � �
CONTRACTOR � `�
� DESCRIPTION �� /�- � �
�
W ❑ FOOTING ❑ DEMO-FINAL SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ LATHE �AAECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
�U ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
c�.� COMMENTS:
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W �WORKSATISFACT RY:PROCEED ❑ PROJECTCOMPLEfE
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� �C�&RECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WFLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on site:
Inspector. � �---
White Copyllnspector's File Canary CopyfSRe Notice
�
DATE T� 3�
CITY OF ORONO CALLED IN
INSPECTION CHEDULED �2-�8�
PERMIT NO. ��'� �O PLETE
ADDRESS Q �-/r � /
OWNER TELEPHONE NO /1��� /� ��°'�/
,
CONTRACTOR '
� DESCRIPTION
��
lN ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ LATHE ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:�� L� /�� � '
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W ❑VYORK SATISFACTORY:PROCEED O PROJECT COMPLETE
� RR T WORK 8 PROCEED ❑iSSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WFLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-46��
OwnerlContractor on site:
�
Inspector. �
Wh e CopyAnspector's File Canary CopylSite Notice