HomeMy WebLinkAbout2016-01505 - gas fireplace r , CITY OF ORONO * 2 0 1 6 - 0 1 5 0 S *
2750 KELLEY PARKWAY DATE ISSUED: 12/OZ/2016
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2040 SPATES AVE
PIN : 10-117-23-31-0090
LEGAL DESC : ORA PARK ON LAKE MTKA
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 5,920.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
HHT GAS FIREPLACE
APPLICANT MECHANICAL 74.00
STATE SURCHARGE MECH(VALUATION) 2.96
FIRESIDE HEARTH&HOME MpIL-IN FEE 2.00
2700 FAIRVIEW AVE
ROSEVILLE,MN 55113 TOTAL 78.96
(651)633-2561 Payment(s)
Minnesota State License#:mech-24512060 CREDIT CARD 4616 78.96
OWNER
DAMMEN,SUSAN
2040 SPATES AVE
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shail 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
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 construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of I80 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.
. L! . � � � l�r �i /(a
Applicant Permitee Signature Date Issued B ignature Date
� 1�30-'16 15:11 FROM- T-480 P0044/0016 F-583
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O � R C(�"Y TJS�ON1.Y
City of Orotto �/��/ �j//� J� ��(�,�/7
� � P.O.Box b6 Aat�ReCotved: � PCC[fIFC{I,��I/�L'1 ' — `�a
� 2750 lCelley Parkway o
Crysrsl Bay,MN 55323 Approycd sy, . Amount S: .a:�.�r'
Phone(952)249-4bp0 Fax(952)249-4616
y`�t.� �e�� CI'T"Y OF ORONO—MECHANICAX, PERMIT
k�S�p (All Commereial permics must be approved by the l�uilding Offieial or Inspcccor andlor Fire Marshalt)
Cr�N�RAL INFORMATZOI�'�'
1. You may apply for mechanical permits by mail or in person at the City officos. Applications will
be reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by return mail a4�cr a review is completed. PE1�M1T5 ARE NOT
VALfD UNTIL'YOIJ R�C�C��A p�RMiT. WOrtI�lVICyST'1VOT$�CYN C�IVTIL THE
PERMIT CA�tT�XS pOST�ll ON THE JOB SIT�.
3. Mechanical Desians w Complete calculations,dctails and specifications are rec�u'rred for each
heating,ventilation,humidification-dehumidification,and air conditioning installation including
heat ioss/heat gain calculatron,design temperatures,eyuipment ratings and identification as Co
type,manufacturer and model. 17ata shall be presented on form provided.
4. When any new construction or remodeling is involved,a separate bu'rCding permit must be
obtaintd.
5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code
rtquirements.
6. All work must be inspected(rough-in and�nal). Call(9S2)249�4600.
(24-48 hour notice required)
7. '!-Touse Heat;ng Test Record musf be submitted before final.
T'Y�p�O�'P�RIvIIT �
� Check A1[That A I
❑Reside❑tiat ❑Commercial(Approval 12equired)
•�]�ew ❑Additional ❑Repairs Q 2Leplace
7
Job $ite/Qwrier Tnforrnation: :'
Site Address: Z U
Qwner• �D �i � , �Q/1�
S5: � ���
,c�-�,� �� �1����2.G�7" z�p: � ��
Home phvne: •���Z�[�!�L�nate phone:
Contractor InForination:
CQntraCtor; FfRE51DE HEARTH & HOME Contact�'erson; L.eah
Address: 27Q0 Fairview Ave N State Bond#:BC662656, MBfi62572, PC6S2571
��ty; Roseville, MN Zip;55113 �xpiration Date:
Phdne: 651-633-2561 AI[ernate Phone:Leah#651-638-3312
❑ rnsurance—Current:
1
11-30-'16 15:11 FROM- T-480 P0005/0016 F-583
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?`..�'-:'r.'�'r���i���nQ..'-,5�. ..�.. - ---'' '^'" a '° _��.r-�"'' ___
1Vote: All Ge�thermal Systems wili now reyuire a Site Plan&Review by our�uilding Official.
IS THIS GEOTHERMAY.? ❑�'es ❑No
H�ATING SYSTEMS
Quantity:
Make:
Model: _
�uel:
plue Size:
Input BT"[ls�
Output BTUs:
CFM�
COOLING S'Y'ST�MS
Quantiry: _
Make:
Modzl:
'Tons:
H.Power
�YR�PLACES
� Gas Pactory Fireplace �rand Name: �(r �
❑ 'OVood Burning Fireplaca
p Wood Stove Modet No.: _��,7,,,,�
❑ Wood Stave with Fluc/Masonry
VENTyY.ATYON
❑ No. Kitchen Exhaust duct _recirculating cfm
❑ No. Bath�xhaust(must havo duct outside) cfm
❑ No. Othzr pans: 1C,ocations cfm
�U�L STORAGE (Musl be approved by Fire M�rr�hnl/ifproposVng to abandon tank in pface.)
❑ Inst�llation ❑ Removai
Pue!Qil: gallons ❑ Undergrnund ❑Tnside ❑Outside
LP Gas: galtons
Othor:
CAS�.IN��N�,Y
❑ Out@oor Crrill ❑ Othor/List What&Where:
. 2
11-30—'16 15:11 FROM— T-480 P0006/0016 F-583
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❑ Yes,this section applics
The replsCemen[of 8 Residentisl fixture or appliance that meeis all three of the following rcquirements;
1. boes not require modi�cation to electrical pr gas service.
Z. �Tas a total cost of$500.00 or less;cxcludine the cost of the�xture or appliance:and
3. Ts improved,installed or replaccd by thc homeowner or licensed contractor.
Skip next section,if this applies; Cost of Permit $ I5.00
5tatt Surcharge $ . 5.00
Mail-In Fce(If App)icable) $ 2.00
Tot�l Permit�ee $
�_� .. _
C� �:�-}y�y.� jy +� p;�TA,� n*T �y �cn �_
.
��s��wi.~:�t',���...����,�=;�x�'.,�� ,i��L�.Lx,t�:+,f.? �`,.z'S%��?'��l�:�J.'!.`�-�^-.4� ,.h�'„'�`_�, � �� ��!�Q=._.��..:��'- '„�r,ll�`�.,�.'��
If above does not apply;follaw guidelines belaw:
1. COIVTRACT PRICE * is 1.25%of contract price with a(Iviinimum�ee of�50.00)
�� �'�� x.0125$ ���
(cantract prico} (minimuro 550.00)
2. STAT�S�IRCHA�tGE �(� M'7 ry� � �
/ G~� x.0005 $ �
(Cantract prico)
3. POSTACrE&HANDLING{Only on Mail-In Applicat'rons) $ Z.00
�� ��, ��
4. TOTAY.PERIVTTT FEE(Add Linas 1-3 Above) $
� * CONTRAC7' pItTC� or JO� COST means the actual or estimated dollar amount charged for the
permitted work including materials,labor,profit, and other f�xtd costs, It is tha amount to be charged
to the customer for she work done. Tf any material,equipment, labor or installations are f�►m;shcd by
the owner,tenant or any other party,the reasonable market value of such ittms must be added to the
esiimated cost or contract priee for permrt fee purposes. Tn the event that thcre is a dispute on thc
amount of the job cost,the Ciry may request the submission of a signed copy of the actual contract.
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r';*��`f?'�:f S}�,���,e....dY�A-!,�����,N �'r'�( •i�� $ � (;� �y ;f. �}�`�'x, :�r,ah„'4?. .�1�f,f��� N�
�. �Z�,:iRS U�' � �.�� '�� ...,l�ii3lfN/"+,'X .ta. �1.f��G,�:�h��i
The urtdersigned hereby applies Co the Ciry for issuance of a Mechanical Permit, agrees to do all
work in strict aceordance with the ordinances of the City and the regulatians pf the $tate af
Minnesota, and eertrfies that alt statements made on this �pplication are complete, true and
correct.
ApplicanC's Signatur� � �� _ l7ate; S�
3
�/� ��_
DATE TIME
CITY OF ORONO cnLLED IN /Z-��.h
INSPECTION NOTIC SCHEWLED /a� ._/ � �
PERMR NO. ��� coM ereo
ADDRESS D � �
OWNER TE EP ONE NO. s��3 3 -�� �`
CONTRACTOR e G `�G����� ��-�
. D
� DESCRIPTION Q- �-- �� �-�"
ty ❑ FOOTING ❑ DEMO-FI AL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
�Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL , ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
Q O'WNENCOI�fTRACTOR TO MEET YW: YES._NO
� COMMENT'� �C � ��� 1 �` �
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W ❑VMORKSATISFACTORY:PROCEED �PROJECT COMPLETE
� ❑CORRECT WORK 3 PROCEED �ISSUE CERTIFlCATE OF OCCUPANCY
W
� ❑CORRECTVYORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CONERINO PERMANENT
�CORRECT UNSAFE CONDITION WRHIN HOURS. p pHOTO TAKEN
INSPECTOR NflLL RETURN
❑5TOP ORDER POSTED.CALL INSPECTOR ��TATION ISSUED
�ISPECTION REUUIRED.CALL TO ARRANGE ACCESS.
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Catl for the next inspection 24 hours in advanoe. (952) 249-4600
OwneNContractor on site•
Inspector: d
VYhite CopyAnapectw's File Gnary CoprlSHa Notics
� �
� �� DATE TIME
CITY OF ORONO cnLLED IN ��
INSPECTION NOTICE �. SCHEDULED l L7 � ____��S�f-�!Y'1
PERM�T NO.��'�����%I��J COMPLEfED
ADDRESS .��J� ` � �.c f-'
, .
OWNER TELEPHON /NO.�i���{� �=�'7�
CONTRACTOR �'�1' i �_,, �r����'��
'' DESCRIPTION � <� c� l �--��.� ,L-i�'�,�/���
� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLINO
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
��TION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
`� ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑SIE�TIC INSTALL
i OMINEA�COI�ITRACTOR TO MEET Y�OU:�L YES_NO
,��
� COMMENTS: ,
� F'K�s�f�5 - De✓ 5i��� -
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j �' Vo,tit.rc-� �o�e.io-�c�s v�✓� c� rn- a��.�
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� ❑NIORK SATISFACTORY:PROCEED ECT COMPLETE
� �CORRECT VMORK L�PROCEED ❑I CEFiTIFICATE OF OCCUPYINCY
O �CORRECTVMORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE(bMERINO pER1iAANENT
❑CORRECT UNSAFE OONDITION WRHIN HOURS. p pHpTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �GTATION ISSUED
❑INSPECTION REf�UIRED.CALL TO ARRAN(3E ACCESS.
CsY tor the next h�spectfon 24 hours in edvance. (952) 249-48��
OwneNConirector on site:
Inspector: � i �.1�-
Whlb CopYAnspectw's FIN Can�ry CopylSlh Notia