HomeMy WebLinkAbout2014-00804 (mechanical-gas fireplace) r
CITY OF ORONO * z 0 1 4 - 0 0 8 0 4 *
' 2750 KELLEY PARKWAY DATE ISSUED: 07/29/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2625 CASCADE LA
PIN : 33-118-23-11-0116
LEGAL DESC : STONEBAY FIFTH ADDITION
: LOT 006 BLOCK 001
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 1,200.00
NOTF�,: HEATILATOR GAS FP
APPLICANT MECHANICAL 50.00
STATE SURCHARGB MECH (VALUATION) 0.60
FIRESIDE HEARTH & HOME MAIL-IN FEE 2.00
2700 FAIRVIEW AVE TOTAL 52.60
ROSEVILLE, MN 551 13
(651)633-2561 Payment(s)
Minnesota State License#: mech-20512060 CHECK 2004598 52.60
OWNER
BUILDERS LLC, STONEBAY
16135 55TH AVENUE NORTH
PLYMOUTH, MN 55446-
AGREEMENT AND SWORN STATEMENT
'l�he 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. 'I�his permit is fbr only the work described and does
not grant permission for additional or related work which requires separate
pemii[s. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified hcrein.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 responsibie for assuring all required inspections are
requesled in conformance with the State Building Code."I his permit may be
revoked at anv time tbr due cause.
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Applicant Permit�e Signature Date Issued By S� ature � Date
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' FOR CITY USE ONLY
��O^,O City of Orono
<y P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
�� Crystal Bay,MN 55323 Approved By: Amount$:
� Phone(952)249-4600 Fax(952)249-4616
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lqkEStI���G CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector 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 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 DesiQns—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,eyuipment 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 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: �'�l � >/ I � � � �Q I/ J
��
Owner:aS�'IA,� CU����' Mailing Address: I��� I P�(h�(�-� ��
City: `�)�_�'(W ` Zip: ����..�
Home Phone: Alternate Phone: �,� � ����
Contractor Information:
�EFa�2TFS & �tC7�1E�ECHNnLOGIES
�ba FIRESID� HEARTH & HOME
Contractor: Contact Person: o ir F3C662656
2700 FAIRVIEW AVENUE N
Address: State Bond#: ROSEVILLE, MN 55113
6 . ,
City: Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance—Current:
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MECHANICAL SYST� ' � ' EING 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
FIREPLACES
Gas Factory Fireplace � Brand Name: ������.�
� Wood Burning Fireplac
❑ Wood Stove Model No.:
❑ Wood Stove with Flue/Masonry j�;
tx
VENTI:,ATIfl�'
❑ 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 MarshaU if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
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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 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 Permit $ 15.00
State Surcharge $ 5.00
Mail-In 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. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
l�� X.o��s$ ��
(contract price) (minimum 550.00)
2. STATE SURCHARGE � /�
C��J 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. 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 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.
MECHA1vICAL PERMIT APPLICATION AGREEMENT
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
wark in strict accordance with the ordin the City and the regulations of the State of
Minnesota, and certifies that all st ents made n this applic �ian are mplete, true and
correct.
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Applicant's Signature: Date: �
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