HomeMy WebLinkAbout2016-01058 - gas fireplace MINE 111111IN111
CITY OF ORONO * 20 1 6 - 0 1 0 5 8
2750 KELLEY PARKWAY DATE ISSUED: 08/30/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS 660 TONKAWA RD
PIN 05-117-23-33-0016
LEGAL DESC PARTENS POINT 1 ST DIV
LOT 003 BLOCK 000
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : S 13,755.90
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
NEW:GAS FIREPLACE(HHT)
APPLICANT MECHANICAL 171.95
STATE SURCHARGE MECH(VALUATION) 6.88
FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00
2700 FAIRVIEW AVE TOTAL 180.83
ROSEVILLE,MN 55113
(651)633-2561 Payment(s)
Minnesota State License#:mech-20512060 CREDIT CARD 4608 180.83
OWNER }
LADD&CAROL STAINBROOK,MICHEAL
660 TONKAWA RD
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 grant 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 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.
0. z 'A
Applicant Permitee Signature Date Issued By Signature Date
08-30-'16 10:22 FROM- T-038 P0001/0004 F-045
Z�0 -000
.'. QR CCTV TJS.E ONLY
City of Orono :`•'` �n /
P.O.Box 66 T3ate Received: 4 Permit�R'.!�'r!X' L5
2750 Kelley Parkway d�
Crystal Day,MAT 55323 Approved By;' /-�.Ainount.S:^a.•'.��. • �3
Phone(952)249-4600 Fax(952)2494616
CITY OF ORONO–MECHANICAL PERMIT
x
$HOQ` (All Commercial permits must be approved by the Building Official or Inspector and/or Fizz Marshall)
.CrENERAL`1NFORNIATION' ; : : . • :.:•;;: ,... ... : : : ... .� :. . . . •.
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
P)EWdlT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Designs—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air conditioning installation including
heat Ioss/lteat 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 permit must be
obtained.
5. All work must be done in accordance with the'U'niform 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.OFPERNIIT.':.
(Check All-That A J,')F7777. .
.
Residential ❑Commercial(Approval Required)
New ❑Additional ❑Repairs ❑Replace
lob;Site/Ovvrier:Xnformation:
Site Address: �t08 �� a w ck Rot d
Owner: Lqd U f�l bfnnkMailingAddress:
City: 6-e OV1.4 Zip: j
Sb b SI,r�o ►2 �-�c�c�z
Home Phone: �0 Alternate,Phone:
—r
Contractor Inforrnation:
Contractor: FIRESIDE HEARTH & HOME Contact Person: f h
Address: 2700 Fairview Ave N State Bond#:B0662656, MB662572, PC662571
City: Roseville, MN Zip-55113 Expiration Date:
Phone: 661-633-2561 Alternate Phone:
❑ Insurance–Current:
1
08-30-'16 10:22 FROM- T-038 P0002/0004 F-045
Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes ❑No
HEATING SYSTEMS
Quantity: 11
Make: T'
Model: A4 tZU JZ Sr
Fuel: C7�S
Flue Size: Q
Input BTUs: 4000
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons.
H.Power
FIREPLACES
Gas Factory Fireplace Brand Name:
Wood 13uming Fireplace
❑ Wood Stove Model No.: Me�,�-z-o—7Z
❑ Wood Stove with 1 lue/Masonry
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) afm
❑ No. Other Fans: Locations efm
FUELSTORAGE (Must be approved by 147re Marsliall ifpropwing 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-
2
08-30-'16 10:22 FROM- T-038 P0003/0004 F-045
e
❑ 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. Hasa total cost of$500.00 or less;excluding 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 Of 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$50.00)
13 -71
.90 x.0125$ `
contract price) (minimum S50p.00)
/3757r
2. STATE SURCHARGE 3 7� •(T`` �49x.0005 $ l 0 • 99 o
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ -7
• " 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.
RIMINI
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: r Date: V� l
3
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NO CE SCHEDULED
PERMIT NO. -O^ COMPLETED
ADDRESS 110"ke-oJ4 /ems
OWNER _ TELEPHONE NO.
CONTRACTOR ��ro S•�` ;6'�
DESCRIPTION
W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
�j ❑ DEMO-SITE ❑ SEPTIC INSTALL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
GAiro nCo-x— CW,
Lu
ac
Z
40
rCXs�
r
W ❑WORK SATISFACTORY PROCEED ❑PROJECT COMPLETE
RK&PROCEED O ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING, PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTO TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnedContractor on site:
Inspector. v
White CopyAnspectoes File Canary Copy/Site Notice
TIME
CITY OF ORONO CALLEDIN
INSPECTION NOTI%�L_Al
bEDULEDT
PERMIT NO. iS Co ETED
ADDRESS -
OWNER TELE NE NO -
CONTRACTOR
DESCRIPTION �-
41 ❑ FOOTING ❑ DEMO-FINAL U ❑ SEPTIC FINAL
❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
RtINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W r❑_AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v
[3 DEMO-SITE 13 SEPTIC INSTALL
Z OWNERICONTRACTOR TO MEET YQQ._YES_NOR, `
�i COMMENTS: LD C& Y A4 )
W
o
Q
1
Uj O WORK SATISFACTORY.PROCEED ROJ
"PECT COMPLETE
W ❑CORRECT WORK&PROCEED O ISSUE CERTIFICATE OF OCCUPANCYI
C 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTO TAKEN
INSPECTOR WILL RETURN
O CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
cal for the next inspection 24 hours in advance. (952) 249-4600
OwnwiComractor on site:
Inspector:
loft FIM Conary Nolic
WMIt aptc