HomeMy WebLinkAbout2007-P11164 (wood fireplace) PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: p11164
Cry'stal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued:
6/26/2007
SITE ADDRESS: 3295 Carman Rd Unit#
Excelsior,MN 55331
PID: 20-117-23-14-0014
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type:
Mechanical Permits Permit Sub-type(s): Wood Fireplace
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 194.38 valuation: $ 15,550.00
State Surcharge Fee: $ 7.78
Misc.Fee: $ 1.50
TOTAL FEE: $ 203.66
APPUCANT: Woodland Stoves&Fireplaces OWNER: Mr. &Mrs. Thomas Lowe
2901 E. Franklin Ave. 3295 Carman Rd
Minneapolis,MN 55403 Excelsior MN 55331
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICAN PERMITF,E SIGNA"I'URF, ISS BY SIGNATURE �
Copies: 1-File(Signatures Required), 1-Applicant, l-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page I
� EOR CITY USE O:�LY
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�� �� ceived: Permit#
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��d By: Amowrt$_
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PERMIT
(All C �� � spector and/or I�ire Marshall)
GENERALIN • � ��
1. You may 1_�a�����d�p the City offices. Applications will
be reviev � « ys•
2. Permit c� eted. PERMITS ARE NOT
VALID I ������ , NOT BEGIN UNTIL THE
PERMI'1 �
3. Mechani< ��� Fcations are required for each
heating,� �nditioning installation including
heat loss/ ratings and identification as to
type,mar _i provided.
4. When any new construction or remodeii�lg is irvoiveu, a separate building per�it r:;zst'��
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 PERMIT �
� � �� (Check All That A ly) � � � �
❑ Residential ❑ Commercial(Approval Required)
❑ New ❑ Additional ❑ Repairs ❑ Replace
Job Site/ Owner Information:
Site Address:��`��� ca""e"R°ad
Owner: Tom Lowe M1111rig AC�C�1'eSS: 109 Whitegate Lane
Wayzata 55391
�ity: Zip:
Home Phone: Alternate Phone: (61z)963-3���
Contractor Information: � � � � ��
Contractor: �'�'oodland stoves&Fireplac� Contact Person: Cinay
2901 E Franklin Avenue RLI 502812
Address: State Bond#:
Minneapolis 55406 10/20/07
City: Zip: Expiration Date:
Phone: (61z)sss-66o6 Alternate Phone:
� OS/26/08
Insurance—Current:
1
• �ZECHANIC:��I. SYST�;MS BrING INS"I'ALLED � � � ���
. HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons: _
H. Power
FIREPLACES
❑ Gas Factory Fireplace
❑� Wood Burning Fireplace
❑ Wood Stove
❑ Wood Stove With Flue
Brand Name: Isokern Model No.: g0036&80046
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfin
❑ No. Other Fans: Locations cfm
FUEL STORAGE(MUST BE APPROVED BY F[RE MARSHALL)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ [nside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What& Where:
2
. � P��RIvIIT FEE CALCL.1�,�1TTC�N(S) '
j BASI;D OFP - 2002 STA'I�I.: STt�TUE �}^.:
❑ 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. Has a 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 $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $
£, , �
�£ ��'������ C �C`n � ��� \���'� � F` l.��:,�'�`�
If above does not apply; follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00)
15,550.00 x .0125 $ �9438
(contract price) (minimum$35.00)
2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of�.50)
15,550.0o x .0005 $ ���g
(contract price) (minimum$ .50)
3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 1.50
203.66
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 ftxed 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 far 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 STATE SURCHARGE is .0005 of the Building Department at(952)249-4600 for the price.
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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: �-<' /o`�O/p�0^7
Reset Form
3
FOR CiTY USE ONLY
,�` City of Orono
O�O`vO P.O.Box 66 Date Received: Permit#
�ti�.;,,,_ 2750 Kelley Parkway
a �' C stal Ba ,MN 55323 Approved By:(If Required):
�Il`-' >;�,- �' ry Y
yit+ ����+i���a~ (952)249-4600
�$axa
CITY OF ORONO —WATER METER FORM
(*Note:Some pemiits may require approval Uy the Building OCTicial and/or Public Works Deparmient*)
GENERAL INFORMATION
1. WATER METERS must be picked up and paid for at City Hall.
2. If possible, fax in this application ahead of time; we will then call you and let you lcnow we have
the water meter in stock. Fax Number: (952)249-4616. Also,you can cali ahead of time to make
sure we received the fax, or to wani us that the fax is conung.
3. WATER METERS must be set and sealed by Orono Water Department (952) 249-4600,
upon completion of ineter installation.
TYPE OF PERMIT
(Check All That Ap ly)
�
,�Residential(May Require Approval) ❑ Corrunercial(Approval Required)
�New Meter ❑ Additional Meter—For: ❑ Replacement Meter
Job Site /Owner Information:
� -:: ; �
Site Address: , S .� ;',� � �;; �< -���� �rl
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: �/����?� �����t Contact Person:
Address: `/ State License #:
City: l�U�/��f(h�� Zip:�'�iExpiration Date:
Phone: (��7����� Alternate Phone:
2007 - WATER METER PERiV1IT FEES
❑ 5/8"METER-$240.00 ❑ 3/4"METER- $291.00 �"METER-$356.00
❑ 5/8"HORN -$ 44.62 ❑ 3/4"HORN -$ 49.03 [� 1"HORN -$ 73.12
� "WATER METER (THESE WILL HAVE TO BE SPECIAL 0[iDERED&PRICES DETERVIINED)
1. METER FEE: $ ���ji. DD
2. HORN FEE $ ��' ��'
3. TOTAL PERl�TIT FEE(Add Lines 1-2 Above) $ � r • ��
CITY-USE ONLY
BRAND: ,/�/��
SIZE: ❑ 5/8" ❑ 3/4" ,(�1" ❑ Other "
SERIAL#: ` -!��7 0��
ERT HIGH#: III�II�����I�����I�I���II�I II (if applicable)
— 1810049624
ADDITIONAL INFORMATION—WATER METERS
The unciersigned hereby applies to the City of Orono for issuance oi a water meter perrriit, ab ees
to do all work in strict acc:,:dar.c;,with tl:e o:dir.ances ef the City an�?the reg�ilztions of the State
of Minnesota, and certifies that all statements made on this application are, true and correct.
ti
A licant:-- �-,�� Date: .S—C� �
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Orrgirz«I: I-�ldrlress File
Mak� Copies For: 1- Utiliry Bzlli�zg Deparb�ier��t 1- Cns1i Dravver