HomeMy WebLinkAbout2011-00509 - gas fireplace CITY OF ORONO PERMIT NO.: 2011-00509
� 2750 KELLEY PARKWAY
� ORONO, MN 55356- DATE ISSUED: 06/23/2011
952 249-4600 FAX: 952 249-4616
AD ESS : 3120 SUSSEX RD
PIN : 04-117-23-32-0009
LEG L DESC : FOX BEND
: LOT 003 BLOCK 001
PER IT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CON�TRUCTION TYPE : FIREPLACE-GAS
VAL ATION : $ 8,900.00
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APPWCANT MECHANICAL 111.25
UTO ATIC GARAGE DOOR&FIREPLACE STATE SURCHARGE MECH(VALUATION) 4.45
8 00 1 TH AVE N
ITE 1000 TOTAL 115.70
HAM LIN, MN 55316
( 63)5 1-2525
OWNER
DE SON, BRETT& STEPHANIE
3 20 S SSEX RD
L NG KE, MN 55356-
AIGREEMENT AND SWORN STATEMENT
7' e worlQ for which this permit is issued shall be performed according to
t e appr ed plans and specifications,applicable City approvals,and the
S ate Bui ding Code. This permit is for only the work described and does
n t grant rmission for additional or rela[ed work which requires separate
p rmits. II provisions of laws and ordinances governing this type of work
s all be c mpied with whether or not specified herein.This permit will
e pire an become null and void if construction authorized is not
c mmen d within I 80 days of the date of issuance,or if construction is
s pende or a period of 180 days at any time after work has commenced.
T e appli nt is responsible for assuring all required inspections are
re uested i conformance with the State Building Code.This permit may be
re oked a ny time for due cause. !� ���
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A plica Permitee Signature Date Issued By Sig ature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
� FOR CITY USE ONLY ^
� City of Orono (5(,� '�',��.�
�I � � �� '�� P•O.Box 66 Date3teceived: " Percnit# �� '�
2750 Kelley Parkway , �
� � �� ;'' � Crystal Bay,MN 55323 APprave8�iq:.; Amovnt$:��.
�goy Phone(952)249-4600 Fax(952)249-4616
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CITY OF ORONO—MECHANICAL PERMIT
li (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
', GENERAL INFORMATION
'�I 1. You may apply for mechanical permits by mail or in person at the City offices. Applications will
I be reviewed and a pernut will be issued within two working days.
, 2. Pernut 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
I PERMIT 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 installarion 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 pernut 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 PER`1VI1�
Cheek Ali Tlia.t A 1 �
�Residential ❑ Commercial(Approval Required)
❑ New '�Additional ❑ Repairs ❑Replace �
'Job Site/Owner Information:
Site Address: ,��o?O Sv S�sY ��•
Owner: �%-��"'��� Mailing Address: S��Q Li'`��°�'`� '��
City: /w/•✓rr�is�- Zip: g S Y3!o
Home Phone: lo/o?— S�7-33 7 u Alternate Phone:
I Contractor InfQrmation:
Contractor: �!/lei'�'�1�� D�1�����ontact Person: Z=�'f �45����
Address: ��a� ��f��"`� State Bond#:
I City: ��i�4�✓ Zip: ��✓�Expiration Date:
Phone: 7�03�"S7�'"7a�p 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 BTiJs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quanrity:
Make:
Model:
Tons:
H.Power
FIREPLACES
� Gas Factory Fireplace Brand Name: A✓�KG�� �W^�Y"��"�r
Wood Burning Fireplace
❑ Wood Stove Model No.: G/Nl/�tQ C y2
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfin
❑ No. Bath Exhaust(must have duct outside) cfin
❑ No. Other Fans: Locations cfin
FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.)
❑ 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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❑ Yes,this secrion 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.
Ski next section if this a lies• Cost of Permit
p , pp , $ 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$50.00)
d/� �� x.0125$
(contract price) (minimum$50.00)
2. STATE SURCHARGE
x.0005 $
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 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 installations are furnished 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 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: �"Z����
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