HomeMy WebLinkAbout2018-00191 - gas fireplace r w
CITY OF ORONO * 2 0 1 8 - a 0 1 9 1 *
2750 KELLEY PARKWAY DATE ISSUED: 02/23/2018
ORONO,MN 5535Cr
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 1720 SHADYWOOD RD
PIN : 17-117-23-21-0019
LEGAL DESC : SHADY-WOOD
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL -
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 3,795.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
HHT GAS FIREPLACE
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.90
FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00
2700 FAIRVIEW AVE
ROSEVILLE,MN 55113 TOTAL 53.90
(651)633-2561 Payment(s)
Minnesota State License#:mech-20512060 CREDIT CARD 4616 53.90
OWNER
HANSBERGER,TRAVIS
651 LEXIE CT
EAGAN,MN 55123-
AGREEMENT AND SWORI�i 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 separate
permits. All provisions of laws and ordinances governing this rype 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 permit may be
revoked at any time for due cause. �
� �� �,, �-�
Applicant Permitee Signature Date Issued By ature Date
02-23-'18 06:40 FROM- T-557 P0001/0404 F-001
' ��c�3� g1�- a�o j
�OR "Y�'Sh O\LY
Cyty of Oror,o
^ �Q� P.O.Box 66 Data ftecei � Pemiii�
� 2750 Kelley Parkway
Crys�al Bay,MN 55323 Approvcd By: Amortnt S:
Phone(952)249-4600 Fax(952)249-4616
y� ti�
r'�kFSHo��'G CITY OF ORONO—MEC�TANYCAL PERMIT
(All Commercial permiis must be approved by the BuilGing O�cial or Tnspector and/or C�ire Marshalq
GENERAL�O�tMAT10N
1. You may apply for mechanieal perntits by mail or in person at tl�c City officcs. Applications will
be reviewed and a permit will be issued wiihiii two working days.
2. Pe�mit cazds will be sent by retum mail after a rcview is completed. PERMITS ARE NOT
VALlb CJNTIL�'OU RECEIVE A PERMYT. 'V'�OXtK 1�1�JST N'OT��CYN Y1'N'TTL THE
P�RI�ITT CARD IS POSTED ON'TH�JOT3 SC'�'�.
3. Mechanieal besiens—Compietc calcutations,details and specifications are required for eaeh
heating�ventilation,humidification-dehumidification,and air conditioning instailation includil2g
heat loss/heat gain calculatlon,design temperatures,equipmtnt ratings and identification 2s to
type,manufacturer and rnodel. bata sllatl be presenCed on form providcd_
4_ Whcn any new construction or remodeling'rs invol'ved,a separate building permit must be
obtAined.
5. AII work must be done in accordance with the Uniform MeChanical Codc/Stste Building Code
rec�uirements.
6. All work must be inspected(rough-in and final). Cali(952)249-4600.
(24-48 hour notico requEred)
7. House Heatirig Tcst Record must be submitted befarc final.
TYPE OF PERMIT
(Check All That Appl�)
��#Ettt�� ❑��,^-�r.�s�ci���.�"� XQv��u��'�
��.
^.��:r�ai�: ��.
� !G,.. ❑,��d��� ❑'�� ��?`�1���.
Job Site/Owner Information:
.��-���:, :.�,.. ��L ��� �
��er;i �. ���'� l ..c�� i '��"�j.'S����5;. S�v� Cr ItitC:D/✓1 ��J f 1 �
Ci;'" Zl':�
:7M.4 w,'(i �� r l ` �{/�V`�
Hom :� 'Qfie: Alternate l�hone:
Contractor Info�-mation:
Contractor: ��RESID� HEARTH&HOME �ontact Person: dv��-�✓
Address: 2700 FaiNiew Ave N State Bond#:BC662656, M6662572, PC662571 O
C� Roseville, MN Zi •55113 �x iration Date: �
h'' P' P 1 ►
Phone: 657-633-2561 Alternate�hone:�651-638-3312
❑ Insurance-Current:
� 1
02-23—'18 06:40 FROM— T-557 P4002/0404 F-001
.- .
: 1V�CHAN'YCAT�.SY'STBMS�.BE�N��XNS'�A�,�;�D :. .�. ' . . .
Notie:All 4cotherrnal Systcrns w�ll now�equire a Site plan&Revie�v by our Building Official.
1S THIS CEOTHERMAL? ❑Yes 0 No
�EATYiVG SYSTEMS
Quantiry:
Make:
Model:
Puel:
Plue Size:
Input BTUs:
Output�TUs: .
CFM:
CUOX.XNG S'YS'fE1�IS
Quantity:
Makt:
Model:
Tons:
H.Power
.�..,. Y.�.
, .... ,. .
1REPLACES
,.,.'.,�,- —�-�r,'� ri�
...,, ,;,,;...., .
� Oas�'�cto -1?�r� 1�_, i�d.N�iiu: -�.�
, �3,`::, 1�,
4QS�.B.i�i� �ir`eP��J �.::;. : �:: ".', -
�,:
❑ Wb'�d;S oye� IYlo.de No� � _ �:_`� T
�,. , �.-..-�.- ��� .� �'=� -
❑ Wg d..Stbve�vtinth�'lue)114!lasoii
VENTILATION
❑ No. TCitci�en�xhAust duet _recirculating cfm
� No. Batla�xhaust(must have duct outsida} cfm
❑ No. Other Fatas: Locations cfin
F[JEL,STORAGE (rYlt�st be approved by Fire 1binrshal�if proposi��g to abpnt�o�t tank fu nlace.)
❑ Tnst�Elation ❑ Removal
�uel pil: gallons ❑ Undergrotind 0 Inside Q Ouuidr
LP Gas: gallons
Othcr�
G�1S LINE O�ILY
0 Outdoor Grill ❑ Other/List What&Where:
2
, 02;23-'18 06:40 FROM- T-557 P0403/0404 F-001
,., ., ...... �. .
. .:, -
,.:
: ..,: . .
, PBRIV�XT.:��E.CA�GT�,A,'�ION(S) ;
`$ASfiD�4��:'2 :2 �1. T U
�0 ST �'�.S .A:T �'`�.°� ;
❑ Yes,this section applies
The replaCtmant of a�i'esidential fixture or appliancz thst meets all three of tl�e following requirements;
1. Dots not require modification to eleetrical or gas scrviee.
Z. Has a rotal cost of$500.00 or less;excludine the cost of the fixture or appliance:and
3. Xs impro�ved,installed or replaced by tlie homeowner or licensed contractor.
Skip ne1►t seCtion,if Chis applies; Cost of Permit $ 15.00
$tAte$UrChArgc $ 5.00
Mail-7n Frc(Yf Applicable) $ 2.00
'�otal permit Fee $
,: ,� .`;'` .�:::•��:PERiVIYT:.�EE�CA�GU`�:ATI�N(�.._.�J'OBS QVER$S.OQ:OQ''�:,`:�::..::::::�: ':�.:�,
If above does not apply;follaw guidelines below:
I. C4NTRr+►CT PRICE " is 1'?5%of contract pricc with a(Mix�imum�ee ot$50:00)
� � �� fy('���� �( �„-�,- ;,r N��v.��:��..,.
�•"•0..�.�y�. �'�. :4� P���:!A il:A..}'i:::
U F ��o� '' S Q�
a. sTar�s�u�c�A�t�� � (, �j�
_ `� :000;s;>�j ! {
�� �����
3. �OSTACy$&HANDLING(Only o�Mail-In Applications) �$' ��;';;a;;�l:�;°'.�;
�,�'..��'�•r�""',�r.`";"-:;.
4. TOTAL r�XtH�ITT��� Add Lincs I-3 Above •� ;��„;rt' �:::�i;�
� ) $;:;�R'-� r. i,i.�,, ,c:s,:; ,
■ �` CONTRACT PRICE or JpB COST means the actual or estimated dollar amount charged for the
permitted'uvork including materials,labor,proft,and o[her�xed eosts. It is thc acnount to be chargcQ
to tlt;e customer for thc work done. If any material, �quipment,labor or installations are furnished by
the owner,tena�it or any other party,the reasonable marktt value of such itcros must be added to the
estimated cosE or contract price for permit fee purposes. In the event thRt there is a disputc on the
amount of the job Cost, tlle City may request the submission of a signed copy of the actual contract.
. ..
� :'MECI=IANICAL pfi121Vl�T:APPLT.CATION;ACxREEMENT ; �-: :'. :.:
The undersigned hereby applies to the City for issuance of a Mechanic�l Permit, agrees to do all
�.vork in striet accordance with the ordinanees of the Ciry and the reg�xlations of the State of
Minnesota, and certifies that All Statements made on tk►is application are complete, true and
correct.
r' �,r� � —�C�
Applicant's SigRature: ��t���
3