HomeMy WebLinkAbout2015-00664 (mechanical- gas fireplace) T .
CITY OF ORONO * Z 0 1 S - 0 0 6 6 4 *
2750 KELLEY PARKWAY DATE ISSUED: OS/26/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 2696 CAROLINE AVE
PIN : 20-117-23-24-0034
LEGAL DESC : WESSELS SUBD OF SPRING PARK LO
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTTON TYPE : FIREPLACE-GAS
VALUATION : $ 5,308.26
NOTE: (2)HEAT-N-GLO GAS FIREPLACES
APPLICANT MECHANICAL 66.35
STATE SURCHARGE MECH(VALUATION) 2.65
GLOWING HEARTH AND HOME MAIL-IN FEE 2.00
100 ELDORADO DRIVE
JORDAN, MN 55352 TOTAL 71.00
(952)495-2927 Payment(s)
CHECK 20994 71.00
OWNER
MILLER,CHARLES&JILL
2696 CAROLINE AVE
WAYZATA, MN 55391-
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 sepazate
permits. All provisions of laws and ordinances goveming 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 aIl required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time�or due cause.
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Applicant Permitee Signature Date Issue y Signature Date
.
FOR CITY USE ONLY
��,, `� City of Orono
�V P O.Box 66 Date Received: Permit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By: Amount$:
Phone(952)249-4600 Fax(9�2)249-4616
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���Esxc��`�'G CITY OF ORONO—MECHANICAL PERMIT
_ (All Commercial permits inust be approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL 1NFORMATION
L You may apply for mechanical pennits 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 Desiens—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 Mechar�ical Code/State Buildin;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 �1 )
�Residential ❑ Commercial(Approval Required)
❑ New ,�(] Additional ❑ Repairs ❑ Replace
Job Site/Owner Information:
Site Address: ��I'�..V �UL �v I �1' J�� ' ' V l�
Owner: ��J� ��. ��iiling Address: I�J L�1� ��• �,
City: Zip: � ��
Home Phone: ��-'� �� �`� ��� Alternate Phone: �� �-��� �./ ✓��
Contractor Information:
Contractor:���� ' � � � "� �� I�ntact Person: 1 I �
�� � �� '
Address: � 1 Il/ �� State Bond #: �
� Zi �l�� �x iration Date: � �I 'V'
CitY� � P � p
Phone: ��� � � � ����� Alternate Phone: �
� Insurance—Current: �Q• � • �� � ����"U���
1
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MECHANICAL SYSTEMS �3EING INSTALi,Ev
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:
[nput BTUs:
Output BTUs:
CFNL•
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H. Power
FIREPLACES
�I�`� +o
Gas Factory Firepla��� Brand Name: ��` �`
� Wood Burning Fireplace ` �� ��fl
❑ Wood Stove Model No.:
❑ Wood SCove with Flue/Masonry
�I �Z2� ��
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.)
❑ [nstallation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ [nside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
. �.
PERMIT FEE CALCULATION(�)
��� BASED OFF - 2002 STATE STATUE �
❑ 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; excludin�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([f Applicable) $ 2.00
Total Permit Fee $
PERMIT FEE CALCULATION S -JOBS OVER$500.00
If above r_?oes not apply;f�llow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$_50.00)
��O � ,��� x .0125 $ ✓
(contract price) (minimum$50.00)
2. STATE SURCHARGE ��jOQj �) ,� �, ��
� �� �'�� x.0005 $
(contract price)
3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 2.00
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 fixed costs. [t 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.
� 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.
��t- �� ��?� I�
Applicant's Signature: � i� Date:
� �
3
f\1 DATE TIME �
� CITY OF ORONO CALLED IN
INSPECTION NO ICE SCHEDULED "' l�✓?
PERMIT NO. co PLETED
ADDRESS `� �Sv
OWNER EPHON NO.��So?-�'1'�—�J'"Z'7,Lo
CONTRACTOR ��� �a`��
� DESCRIPTION � �r
4� ❑ FOOTING ❑ DEMO-FINAL ❑ SE I INAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS: 1/�.�tL�'�rtc � c�'us�t-�'�f �or /�l✓, ar(
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W ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS.
C r e nex i • i 24 hou ' ance. (g52) 249-4600
Owner on actor �
Inspector. i �
White Copylinspector's File Canary CopylSite Notice