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Home My WebLink About2010-00855 - gas fireplace CITY OF ORONO PERMIT NO.: 201(�00855 � 2750 KELLEY PARKWAY � ORONO,MN 55356- DATE ISSUEn: 09/17/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 2172 SHADYWOOD RD PIN : 17-117-23-42-0010 LEGAL DESC : WILEYS PARK LAKE MTKA : LOT 000 BLOCK 001 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIREPLACE-GAS VALUATION : $ 7,000.00 NOTE: 3 FACTORY GAS FIREPLACES BY HEAT N GLO APPLICANT MECHANICAL 87.50 FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 5.00 2700 FAIRVIEW AVE ROSEVILLE,MN 55113 MAIL-IN FEE 2.00 (651)633-2561 MISC FEE 0.00 Minnesota State License#:20512060 TOTAL 94.50 OWNER DORE, STEVEN 8351 WEST 109TH STREET BLOOMINGTON,MN 55438- 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 does not grant permission for additional or related work which requires sepazate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified 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 aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. � � ��)'I�CQ�iV � � Applicant Permitee Signature Date Issued By i nature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO � 4 � FOR CI'TY USE ONLY � 04�� City of Orono P.O.E3ox 66 Date Received: Permit# 2750 Kelley Parkway a ." � Crystal Bay,MN 55323 Approved By: Amo�mt$: �e `' 6E Phone(952)249-4600 Fax(952)249-4616 t'+�x�' CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) 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 PERM[T CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desi�ns—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 invoived,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 fmal). Call(952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before final. TYPE OF PERMIT (Check All That A 1 ) �Residential ❑Commercial(Approval Required) �New ❑Additional ❑ Repairs ❑Replace / � Job Site/Owner Information: Site Address: � I�o�Z S�G�y �a�x� �t� Owner: /�Gt G �a r�� v�CS Mailing Address: City: Zip: Home Phone: �lS�o��7!�- $�G�`� Alternate Phone: Contractor Information: Contractor: Contact Person: $719`l�� Hearth&Home Technologies,Inc. �� ,Q,q Address: State Bond#: dba Fireside Hearch & Home �'b a E;e�2 ,��a� 2700 N. Fairview Ave. City: Zip: Expiration Date: ssiisss,�N 55113 �/f � � Phone: Alternate Phone: ❑ Insurance—Current: 1 � � � MECHANICAL SYSTEMS BEING INSTALLED Note: All Geothermal Systems will now require a Site Plan& Review by our Building Official. , IS THIS GEOTHERMAL? ❑Yes ❑No HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: Input BTUs: Output BTUs: CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: H. Power FIREPLACES 3 Gas Factory Fireplace Brand Name: �C�•1 n (��O Wood Burning Fireplace /_ Wood Stove Model No.: V�� L �" Wood Stove With Flue GV-tlt7 � L X VENTILATION s+ 3Co T2 No. Kitchen Exhaust duct recirculating cfm No. Bath E�►aust(must have duct outside) cfm No. Other Fans: Locations cfm FUEL STORAGE (Must be approved by Fire MarshaU iJproposing to abandon tank in place.) � Installation � Removal Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside LP Gas: gallons Other: GAS LINE ONLY � Outdoor Grili � Other/List What& Where: 2 . � � PERMIT FEE CALCULATION(S) BASED OFF -2002 STATE 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;excludin�the cost of the fixture or appliance:and 3. Is improved, installed or replaced by the homeowner or licensed contractor. Skip neut section,if this applies; Cost of Permit $ I5.00 State Surcharge $ 5.00 Mail-[n Fee(If Applicable) $ 2.00 Total Permit Fee $ PERMIT FEE CALCULATION S -JOBS OVER $500.00 If above does not apply;follow guidelines below: 1. CONTRACT PR[CE * is 125%of contract price with a(Minimum Fee of$50.00) 7VU�'� x.0125$ 7. 5� (contract price) (minimum$50.00) 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$5.00) '�(1Uf�•� x.0005 $ � ,j�Z� (contractprice) (minimum$5.00) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 9y,so 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, Iabor or installations are fumished by the owner, tenant or any other party, 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. ■ **The STATE SURCHARGE is.0005 times the Contract Price or a minimum of$5.00. MECHANICAL PERMIT APPLICATION 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:�/4l/O Reset Form 3 �� D TIME � c ��- � ,D c�n oF o�oNo D IN �a INSPECTION e SCHEDULED � PERMIT NO. /-5 MPLETED ADDRESS � OWNER " T PHONE NO. - � g � S CONTRACTOR - � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING F AL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q O RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL � HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO ��., COMMENTS: � W a � � O a � O � W � Q � 2 W � W � � ��WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ IMSPECTION REQUIRED.CALLTOARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (g52) 249-4600 Owner/Contractor on te: Inspector. � � � White Copyllnspector's File Canary CopylSite Notfce