HomeMy WebLinkAbout2012-00780 - wood fireplace CITY OF ORONO � 1 2 — 0 0 7 s 0 *
• "`� 2750 KELLEY PARKWAY DATE ISSUED: 08/13/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2905 SIXTH AVE N
PIN : 28-118-23-31-0006
LEGAL DESC : GARDEN GROVE
: LOT 002 BLOCK 002
PERMIT TYPE : MECHANICAL(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE- WOOD
NOTE: RF,PLACE WOOD BURNING FIREPLACE-KOZY HEAT-MODEL 231 7C
APPLICANT MECHANICAL(<$500) 15.00
ELLINGSON,JORGEN& YUMIKO STATE SURCHARGE MECH(<$500) 5.00
2905 SIXTH AVE N TOTAL 20.00
LONG LAKE, MN 55356-
PAID WITH CC# 7577
OWNER
ELL[NGSON,JORGEN&YUMIKO
2905 SIXTH AVE N
LONG LAKE,MN 55356-
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 gran[permission for additional or related work which requires separate
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 l80 days at any time afrer work has commenced.
The applicant is r o sible 'Asuring all required inspections are
requested in c or an i the State Building Code.This permit may be
revoked at y � �' r d�e`ca /
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�'ant Permitee Signature Date Issu By Signature Date
�' SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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. w� � City of Orono � �� � � � '��� �i
�¢ �0 P.O.Box 66 � �ate�tece��d:� : �� ��'ermit# ��+��� °��O�
2750 Kelley Parkway � �"' �
a� d ,,� � Crystal Bay,MN 55323 .Approved�y�, :Ainaunt S: � �i`
'?� Phone(952)249-4600 Fax(952)249-4616
CITY OF ORONO—MECHANICAL PERMIT
(All Commercia]permits must be approved by the Building Official or Inspector and/or Fire Marshall)
GEI�TEIZA�L Il�O�I.ATI�N
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 cazds 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 Desi�—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 construcrion 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.
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'nesidential ❑Commercial(Approval Required)
❑ New ❑Addirional ❑Repairs �Replace
::Tob���i��l�Dv�i�ez'�nfor�ahon ,>
Site Address: Z� � � c� �' ���. N ,
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Owner: ! � �- �' M�ail-ing Address:
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City: � �-d Zip: S� � S �
Home Phone: �o� Z ���o �-'�Alternate Phone:
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tContra�tor�Tn�ormation: `
Contractor: Contact Person:
Address: State Bond#:
City: Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance-Current:
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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 BTLTs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
PLACES
�C� ��� Gas Factory Fireplace Brand Name: �c�.
� Wood Burning Fireplace
❑ Wood Stove Model No.: Z� t �
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfin
❑ No. Bath Eachaust(must have duct outside) cfin
❑ No. Other Fans: Locations ��
FLTEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in p[ace.)
❑ Installarion ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
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� Yes,this section applies
The replacement of a Residenrial fixture or a lvp iance that meets all three of the following requirements:
1. Does not require modificarion 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 next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $�
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
x.0125$
(contract price) (minimum$50.00)
2. STATE SURCHARGE
x.0005 $
(contractprice)
3. POSTAGE&HANDLING(Only on Mail-In Applicarions) $ 2.00
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 installarions 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 putposes. 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 undersigned hereby applies t ity for issuance of a Mechanical Pernut, agrees to do all
work in strict accordance the o dinances of the City and the regulations of the State of
Minnesota, and certifie at all s t e s made on this application are complete, true and
correct.
Applicant's Si a Date: � ' ` L'
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