HomeMy WebLinkAbout2010-01162 (gas fireplace) CITY OF ORONO PEaM�T No.: 2oio-oi162
' 2750 KELLEY PARKWAY
� ORONO, MN 55356- �A7'E IssvE�: 1U30/2010
952 249-4600 FAX: 952 249-4616
ADDRESS . 3382 BAYSIDB RD IvG�"
PIN : OS-117-23-14-OQ35 ��G��j
LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK
: LOT 009 BLOCK 005
PERMIT TYPE : MECHANICAL(> $500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 4,500.00
NOTE: 2 1IGATN GLO GAS FIREPLACE
6000C
APPLICANT MECHANICAL 56.25
FtRESIDE HEARTH & HOME STATE SURCHARGE MECH (VALUATION) 5.00
2700 FAIRVIEW AVE
ROSEVILLE, MN 55113 MA[L-IN FEE 2.00
(651)633-2561 MISC FEE 0.00
Minnesota State License#: 20512060 TOTAL 63.25
OWNER
HUTHWAITE, M[CHAEL& MARILYN
7715 AINSWORTH DR
GERMANTOWN, TN 38138-
AGREEMENT AND SWORN STATEMENT
The�vork for which this pennit is issued shall be perfonned accordin�to
the approved plans and specifications,applicable City approvals,and the
State Building Code. 'I�his permit is ibr only the work described and does
not grant permission for additional or related work which requires separate
permits. nll provisions of laws and ordinances governing this type of work
shall be compied wiUi whether or not specitied herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the datc of issuance,or if conslruction is
suspended for a period of 180 days at airy timc atter work has commenced.
The applicant is responsibie for assuring all required inspections are
I requested in conformance wilh the State Building Code.This permit ma��be
revoked at any time for duc cause.
i I�K.�-C.l ��. l l
i i
Applicant Permitee Signature Date Issued By ' nature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB VE.
FOR CITY IISE ONLY
04��0 CityofOrono
P.O.Box 66 Date Received: Permit#
� 2750 Keliey Parkway
a � � Crystal Bay,MN 55323 Approved By: Amount$:
��+ ' ' wo` Phone(952)249-4600 Fa�c(952)249�616
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CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permiu must be approved by the Building Official or Iaspector and/or Fire Marshall)
GENERAL 1NFORMATION
i. 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
PERMIT 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 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 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 fmal). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
Check All That A 1
�Residential ❑Commercial(Approval Required)
�New ❑Additional ❑Repairs ❑Replace
Job Site/Owner Information:
Site Address: .3.3� � (��,r s��e Qo�
Owner: � �a r �t s C��� Mailing Address:
City: Zip:
Home Phone: Alternate Phone: (�l�- 3 3 3-80�o
Contractor Information:
Contractor: Contact Person:
Hearth&Home Tec no s,Inc.
dba Fireside Hearth 8 Home
Address: State Bond#: e 2os�2oso
2700 N. airvie �—
Rosevil�e� MN 55113
City: Zip: Expiration Date: ssl/sss-2ss�
Phone: Alternate Phone:
❑ Insurance—Current:
1
• MECHANICAL SYSTEMS BEING INSTALLED
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 BTUs:
Output BTUs:
CFM:
COOLiNG SYSTEMS
Quantity:
Make:
Model:
Tons:
H. Power
FI REPLAC ES
O� Gas Factory Fireplace Brand Name: ���.�.�(,�o
Wood Burning Fireplace
Wood Stove Model No.: (p ovti G , /i�� �-
Wood Stove With Flue
VENTILATION
No. Kitchen Exhaust duct recirculating cfin
No. Bath Exhaust(must have duct outside) cfrn
No. Other Fans: Locations cfin
FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in plac�)
� lnstallation � Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
� Outdoar Grill � Other/List What&Where:
2
� PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
� Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following reyuirements:
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.
Skip ne�ct section,if this applies; Cost of Perrr►it $ 15.00
State Surcharge $ 5.00
Mail-[n Fee(If Applicable) $ 2.00
Total Permit Fee $
PERMIT FEE CALCULATION S)-JOBS OVER$500.00
If above does not apply;follow guidelines below:
1. COPiTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
y svr� . vU X.o12s$ .5�.as
(contrnct price) (minimum 550.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$5.00)
��_j v'U' vt� x.0005 $ S �
(contract price) (minimum$5.00)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ G 3. ? S
■ * CONTRACT PWCE or JOB COST means the actuai 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 fumished by
the owner, tenant or any other parly,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 sigr�ed copy of the actual contract.
■ **The STATE SURCF�ARGE is.0005 times the Contract Price or a minimum of$5.00.
MECHANICAL PERMIT APPLICATION AGREEMENT
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: /�k�/�
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