HomeMy WebLinkAbout2014-00788 (mechanical- gas fireplace) CITY OF ORONO * 2 0 1 4 - 0 0 7 8 8 *
' ' 2750 KELLEY NARKWAY DATE ISSUED: 07/24/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2690 CAROLINE AVE
PIN : 20-117-23-24-0033
LEGAL DESC : WESSELS SUBD OF SPRING PARK LO
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 7,500.00
NOTE: (3) TOWN&COUNTRY GAS FACTORY FIRGPLACES SET AND VENT ONLY
APPLICANT MECHANICAL 93.75
STATE SURCHARGE MECH (VALUATION) 3.75
PRACTICAL SYSTEMS MISC FEE 0.00
4342B SHADY OAK RD
HOPKINS, MN 55343 TOTAL 97.50
(952)933-1868 Payment(s)
CREDIT CARD 0961 97.50
OWNER
LIBERMAN, ZN&TAL
1 145 SETTLERS ROAD
MEDINA, MN 55340-
AGREEMENT AND SWORN STATEMENT
I'he work for which this perniit is issued shall be perfornied according to
the approved plans and specifications,applicable City approvals,and the
State f3uilding Code. This permit is tor only the work described and does
not grant permission for additional or related work which requires sep�uatc
permits. All provisions ot laws and ordinances goveming this type of work
shall be compied with 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 date of issuance,or if construction is
suspended for a period of I 80 days at any time afrer wark 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.
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Applicant ermitee Signatu Date Issue y Signature Date
9529331869 17_52 34 07-24-2014 2/4
� FOR CITY USE ONLY
�O^' City of Orono
�y P.O.Box 66 Date Received: Pennit�
� 27>0 Kcllcy Par{:way
; Cryswl[3ay,MN 55323 Approvcd By: _ Amounf S:
I Phonc(9i�)249-4600 Fa�(952)249�i616
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�`'Ars,io�`v CITY OF ORONO—MECHANICAI,PERMIT
__.� (All Commcrcial perenits must be approved by ttx:Suilding OfGcial or{nspector and/or Fire Marshall)
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will
be reviewed and a permit wili be issued within two working days.
2. Permit cards will be sent by retum 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 SIT�.
3. Mechanical Desiens—Comptete calculations,detaiEs and specifications are required for each
heatin�,ventil�tion,humidification-dehumidification,and air conditioning installation including
heat loss/heat gain calculation,design temperatures,ec�uipment ratings and identification as to
type,manufacturer and modei. Data shall be presented on form provided.
4. When any ne�v construction or remodefing is involved,a separate buildino permit must be
obtained.
5. Alt work must be done in accordance with the Uniform Mechanical Code/State Building Code
requirements,
6. All work must be inspeeted(rough-in and final). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating"I'est Record must be submiited before final.
TYPE OF PERMTT
Check All That A 1
0 Residential ❑Commercial(Approval Required)
/
❑Ne�v ❑Additional ❑Repairs (�Replace
Job Site/Owner Information:
Site Address: 1 l o�'�f�7 � .c�_t"�,����C )��I`.
Owner:�,�l�:-��(ti1�1S�1 Mailing Address:
City: ;�,��;i�l) Zip: `'>`>�'�y-U
Home Phone: Alternate Phone:
Contractor Inforn�ation:
Contractor: 1�t�1��;;��.� ��,=,r�����`� Contact Person: ��Cr`�;i I-�l��1
�
Address: �1��'�`1-�i'�, �:,'f'��:�t���i (7�'e�r.�_c� StateBond#: �'V���>> r�,-�,����fU
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City: /����,�>�' �!1�. Zip:<;�-;��,���", Expiration DaCe: a i�;��i`�
Phone: ��I`�-z?�i���� � 1;<���. Alternate Phone:
❑ Insurance—Current:
1
9529331869 17 52 49 07-24-2014 3/4
MECHA.NICALSYSTEMS BEING INSTALLED
Note: All Geothennal 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:
OuEput STUs _ ___
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Po�ver
FIREPLACES
[� Gas Factory Fireplace �'�� Brand Name: ��.>�1�(t� 3 l����,n;��U
❑ Wood Burning Fireplace `
❑ Wood Stove Model No.: �1,�4 2. l_J:.
❑ Wood Stove�vith Flue/Masonry , �
'�.�.� -;,,�, � ��:,���j
VENTILATION
❑ No. Kitchen Exhaust duct _recirculating cfm
❑ No. Bath Exhaust{must have duct outside) cfm
❑ No. _ Other Fans: Locations______�� _ cfm
FUEL STORAGE (Must be approverl by Fire Murslral!if proposi�rg fo abundon tuirk i�r place.)
❑ Installation ❑ Removal
Fuet Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other.
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:__ _._____
2
9529331869 1 7 53 01 07 24 2014 4/4
PERMIT FEE CALCULATION(S)
BASED OFF-2002 STATE STATUE
❑ Yes,[his section applies
The replacement of a Residential fixture or appliance ihat meets all three of tl�e following requirements:
1. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludinQ 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 Pern�it $ 15.00
State Surcltargc $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Pcrmit Fec $
PBItMIT FEE CALCULATION S �JOBS OVER$500.00
lf above does not apply;follow guidelines below:
l. COIVTRAC'I'PRICE *is 1.25°/o of contract price with a(Minimum Fce of�50.00)
-�.�� ;�l x.0125$ ����..�`7
(controct pricc) (minimum SSO.QO)
2. STATE SUFtCT�ARGE
���i Ol> x .0005 $ !�_ .}`�
(contmct price)
3. POSTAGE&HANDLTNG(Only on Mait-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �'��".`'���.J
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted�vork 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, eyuipment, labor or installations are furnished by
the owner, tenant or any other party,the reasonable market vaiuc of such items must be added to the
estimated cost or contract price for permit fee purposes. In the event that there is a dis�pute on the
amount of the job cost, the City may request the submission of a signed copy of the actual contract.
MECHANICAL I'ERMIT APPLICATION AGREEMENT
Tfie undersigned hereby applies to the City for issuance of a Mechanical Permit, agrces to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certi6es that all statements tnade on this application are complete, true and
con•ect.
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Applicant's Signature: ��1�J t�� � _,� ' Date: �"���� ���-�-
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� � �� � T,E TIME ✓
CITY OF ORONO CALLED IN ��
INSPECTION OTIC SCHEDULED �� — ��
PERMIT NO. 'd0 � COMPL�TED
ADDRE
OWNER • LEPHONE NO 3
CONTRACTO
� DESCRIPTION , �'Q
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� ❑ FOOTING ❑ PLUMBIN INAL EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z � INSULATION O WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC I ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI PTIC FINAL DATION/REMOVAL
Q OWNERICONTRACTOR T EET YOU:_YES_NO '
y COMMENTS: �� � ���
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W ❑ RKSATISFACTORY:PROCEED ❑PROJECT COMPLEfE
� CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
�NSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALLINSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 2a hours i advance. (952 49-4600
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopyfSite Notice
� � � �,�- �
�� "` DATE TIME
CITY OF ORONO CALLED IN �D< < 3l�
� INSPECTION NOTICE scHE�u�e� '� ��
PERMIT NO. � �d�"(�.��r�S�oMa�ereo ���
ADDRESS � � �- �
OWNER TEL ONE NOI � ��
C HTRACTOR
� ESCRIP�� ��` ����� ' " �
t� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ 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
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ � TIC INSTALL
� OWNERfCONTRACTOR TO MEET YOU:�YES_NO
v�, C MMENTS:
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W ❑WORK SATISFACTORY:PROCEED OJECT COMPLETE
� ❑CORRECT WORK&PROCEED I UE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY
V BEFORECWERING PERMANENT
❑CORRECTUNSAFECONDITIONWITNIN HOURS. p pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 4�i dva -46 0
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice