HomeMy WebLinkAbout2008-00228 - gas fireplace ` CITY OF ORONO PERMIT NO.: 2oos-oo22g
� 2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 09/17/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 2118 SHADYWOOD RD
PIN : 17-117-23-42-0016
LEGAL DESC : WILEYS PARK LAKE MTKA
: LOT 000 BLOCK 001
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 2,000.00
NOTE:
1 HEAT N GLO DAKOTA GAS FIREPLACE
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APPLICANT MECHANICAL 35.00
GLOWING HEARTH AND HOME STATE SURCHARGE MECH(VALUATION) 1.00
100 ELDORADO DRIVE
JORDAN,MN 55352 • '��
(952)495-2927 TOTAL -�-5$'
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OWNER
HANSSEN,PAUL&LEANN '
2118 SHADYWOOD RD
WAYZATA,MN 55391
AGREEMENT AND SWORN STATEMENT �` �
The work for which this permit is issued shall be performed according to �
the approved plans and specifications,applicable City approvals,and the
State Building Code. 'fhis permit is for only the work described and dces
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if conswction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
,.�� a�� ���l. � i 17 i D� i i
�pplicant Permitee Signature Date Issued By Si re Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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� FOR CTI'Y USE ONLY
,�d`��`. City of Orono
�//O�*' `�O� P.O.Box 66 Date Received: Permit#
�JI + << 2750 Kelley Pazkway
; �t��:',. r!= Crystal Bay,MN 55323 Approved By: Amount$:
� ,. b�-� (952)249-4600
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CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector and/or Fire Mazshall)
GENERAL INFORMATION
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 Desiens—Complete 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
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.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
Check Al1 That A 1
0 Residential ❑Commercial(Approval Required)
❑New ❑Additional ❑Repairs ❑Replace
Job Site/Owner Information:
Site Address: 2118 SHADYWOOD ROAD
Owner: STEPHEN LONGMAN BUILDERS Malllrig AddTeSS: 9401 PRESTON PLACE
C1Ty: EDEN PRAIRIE Zip: 55347
Home Phone: �952)943-8226 Alternate Phone:
Contractor Information:
Contractor: GLOWING HEARTH&HO Contact Person: NDY PIcxus
Adal'OSS: 100 ELDORADO DR State Bond#: at sss.�a6ai
JORDAN 55352 02/15/09
City: Zip: Expiration Date:
Phone: (952)492-9276
Alternate Phone:
❑✓ Insurance—Current:
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HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
� Gas Factory Fireplace
❑ Wood Burning Fireplace
❑ Wood Stove
❑ Wood Stove With Flue
Brand Name: HEAT&GLO Model No.: DAKOTA
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath E�chaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
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� � � i'ERMIT FEE CALCULATI(JN(S)� � ��
� � BASED OFF - 2002 ST'ATE` STATUE �� �
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $
PEFtMIT FEE CALCULATIOI�.S -70BS'�J�R$50�.t?0
If above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00)
2,000.00 x.0125$ 35.00
(contract price) (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50)
2,000.00 x.0005 $ �•00
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ .�
36.00
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 party, the reasonabie 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.
■ **The STATE SURCHARGE is.0005 ofthe Building Department at(952)249-4600 for the price.
MEGHANICAL PERMIT APPLICATIQN AGREEMENT
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made on this application are complete, true and
correct.
Applicant's Signature: �, "� Date: �� G Y '
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