HomeMy WebLinkAbout2012-00077 - gas fireplace ' CITY OF ORO PERMIT NO.: 2012�00077
2750 KELLEY PARK AY
ORONO, MN 5535 - DATE ISSUEn: 02/07/2012
952 249-4600 FAX: 952 249-4616
ADDRESS : 4105 BAYS[DE RD
P1N : 06-117-23-14-0023
LEGAL DESC : BAYSIDE RIDGE
: LOT 002 BLOCK 001
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 5,000.00
NOTL-;: GAS FACTORY FIREPLACE-BRAND NAME-REGENCY-MODEL#H 40E
GASLINE DONE BY OTHERS
APPLICANT MECHA CAL 62.50
STOVE& FIREPLACE STATE S RCHARGE MECH(VALUATION) 2.50
255 HWY 97
FOREST LAKE, MN 55025- TOTAL 65.00
(651)464-9761
OWNER
BURKE,NICK& SUE
4105 BAYSIDE RD
MAPLE PLAIN, MN 55359-
AGREEMENT AND SWORN STATEMENT
l�he tiork for which this permit is issued shall be performed according to
the approved plans and specificauons,applicable City approvals,and the
Sta�e Building Code. This permit is for onty the work described and does
not grant permission for additional or related work which requices separate
pennits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
cxpire 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 afrer work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoke�at a �' e for due cause.
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� �� �.���e 1.(�,�/���'`` l � l � � `i K � 1���
Applicant Permitee Signature Date Is e y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK T ER THAN DESCRIBED ABOVE.
O CI Y USE ONLY
/',¢��;� City of Orono �^ �57. O d 7
f � p,p,goX(,(, Date Receive� � rt# �
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r?���, �;i 2750 Kelley Parkway
j� y;"� �`r � Crystal Bay,MN 55323 Approved By: Amount$:��
�� ��`n y,��;%'� Phone(952)249-4600 Fax(952)249-4616 �
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CITY OF ORONO—MECHA ICAL PERMIT
(All Commercial permits must be approved by the Building fticial or Inspec[or and/or Fire Marshall)
GENERAL iNFORMATION
1. You may apply for mechanical permits by mail or in erson at the City offices. Applications will
be reviewed and a permit will be issued within two orking days.
2. Permit cards will be sent by return mail after a revie is completed. PERMiTS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WO K MUST NOT BEGIN UNTIL THE
PERMiT CARD iS POSTED ON THE JOB SiT .
3. Mechanical DesiQns—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumiditicatio ,and air conditioning installation including
heat loss/heat gain calculation,design temperatures, quipment ratings and identitication as to
type,manufacturer and model. Data shall be presen d on form provided.
4. When any new construction or remodeling is involv d,a separate building permit must be
obtained.
5. All work must be done in accordance with the Unifo Mechanical Code/State Building Code
requirements.
6. All work must be inspected(rough-in and final). Ca I(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitted befo final.
TYPE OF PER IT
(Check A11 That 1
❑Residential ❑Commercial(Approval Require )
❑ New �Additional ❑R pairs ❑ Replace
Job Site/Owner Information:
Site Address: ���� L� -�J� � � �(�1 L� ����
Owner: �h, �F� Maili g Address: �1���
City: Zip:
Home Phone: Alte ate Phone:
Contractor lnforrnation:
Contractor: S�J� � �1��P��� � Cont ct Person: `�'w� �� w� (�
Address: a�� /�w � 7 State Bond#: /-T O � � C� V �
�pirP� f LC,���. �57�.�1� �� � �U � oZ
City: Zip: Expi ation Date:
Phone: �� r �tl'"� '`� 7 �' � Alte ate Phone:
❑ insu nce—Current:
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MECHANI�A��'��°I'�l�rl BE G�TSTALLED '
Note: All Geothermal Systems will now require a Site P an &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
FTREPLACES
,� Gas Factory Fireplace Brand Name: � Ci+� �
❑ Wood Burning Fireplace ; I —j � L� �
❑ Wood Stove Model No.: �1 �� �
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have d ct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by Fire Marshall i roposing to abandon tank in place.)
❑ installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List W at&Where:
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PERMIT FEE C�LCUi,�TION(S)
� �� BASED OFF - 2002 STATE STATUE�� �
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that me ts all three of the following requirements:
1. Does not require modification to electrical or ga service.
2. Has a total cost of$500.00 or less;excluding th cost of the fixture or appliance: and
3. is improved,installed or replaced by the homeo ner or licensed contractor.
Skip next section,if tliis applies; Cost of Permit $ 15.00
State S rcharge $ 5.00
Mail-I Fee(If Applicable) $ 2.00
Total ermit Fee $
PERMIT FEE CALCULATTO. � ' �+(�B�f�"�ER.�5�0,�?�
If above does not apply;follow guidelines below:
1. CONTRACT PRiCE * is 1.25%of contract ice with a(Minimum Fee of$50.00)
� ��� x .0125 $ �� �
(contrac[pri e) (minimum$50.00)
2. STATE SURCHARGE /-�
�UV x .0005 $ �' �
(contrac[pr'ce)
3. POSTAGE&HANDLING(Only on Mail-In A plications) $���_
4. TOTAL PERMTT FEE(Add Lines I-3 Abovc $
� S ' � �
■ * CONTRACT PRTCE or JOB COST means the ac I or estimated dollar amount charged for the
permitted work including materials, labor,profit,and o her fixed costs. It is the amount to be charged
to the customer for the work done. If any material, eq ipment, labor or installations are furnished by
the owner, tenant or any other party, the reasonable m rket value of such items must be added to the
estimated cost or contract price for permit fee purpos s. In the event that there is a dispute on the
amount of the job cost, the City may request the sub ission of a signed copy of the actual contract.
� MECHANICAL�'ET�MTT � ATIU�3 A�REEMENT
The undersigned hereby applies to the City for issuan e of a Mechanical Permit, agrees to do all
work in strict accordance with the ordinances of th City and the regulations of the State of
Minnesota, and certifies that all statements made n this application are complete, true and
correct.
Applicant's Signature: Date: � � � Z
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