HomeMy WebLinkAbout2016-00182 - gas fireplace CITY OF ORONO * z 0 1 6 - 0 0 1 s 2 *
2750 KELLEY PARKWAY DATE ISSUED: 02/22/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1960 FOX RIDGE RD
PIN : 03-117-23-13-0011
LEGAL DESC : FOX RIDGE
: LOT 007 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 4,000.00
NOTE: GAS FIREPLACE(HEAT N'GLO)
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 2.00
FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00
2700 FAIRVIEW AVE
ROSEVILLE,MN 55113 TOTAL 54.00
(651)633-2561 Payment(s)
Minnesota State License#: mech-20512060 CHECK 00020054 54.00
OWNER
STAUBER, ROB
1960 FOX RIDGE RD
LONG LAKE,MN 55356-
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 separate
permits. All provisions of laws and ordinances governing 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 all required inspections are
requested in conformance with the State Bui►ding Code.This permit may be
revoked at any time for due cause. �
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Applicant Permitee Signature Date Issued By Signature Date
FOR CITY USE ONLY
�O A TO City of Orono �/�
�y P.O.Box 66 Date Received: ��ermit#��� � 0
2750 Kelley Parkway n �( r�1
Crystal Bay,MN 55323 Approved By: r1 � Amount$:�
Phone(952)249-4600 Farc(952)249-4616 �v�
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l�kfSH���G CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by[he Building Official or Inspector and/or Fire Marshall)
GENERAL TNFORMATION
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 Desi�ns—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air conditioning installation inclnding
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 pernut 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 noNce 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
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Job Site/Owner Information:
Site Address: � ��v �D X I�:��� F�
Owner: IC o� �a,�,,Ir,�r Mailing Address: /��� �JC F-%d�fG /��'
c�ty: �ro.. n z�p: 5s3 s'�
Home Phone: Alternate Phone: ��v 3-�S�- I�/ 9 a
Contractor Information:
HEART���,h�,,,,O��TECHNOLOGIES Contact Person:
dba F �'fl� EA
Lic BC662656
27(�gA�lIEW lU�F.NUEA1 State Bond#: (� ��/ 5 S � �
ROSEVILLE, MN 55113 .
Cit�s51.633.2561 Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance—Current:
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MECHANICAL SYSTEMS BEING INSTALLED
Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THTS GEOTHERMAL? ❑Yes ❑No
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Makc:
Model:
Tons:
H.Power
FIREPLACES
� Gas Factory Fireplace Brand Name: ��F.�� V l�
Wood Burning Fireplace ` r u n� ����'G
❑ Wood Stove Model No.: �9
❑ Wood Stove with Flue/Masonry
V ENTILATION
❑ No. Kitchen Exhaust duct recirculating cfin
❑ No. Bath Eachaust(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.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
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PERMIT FEE CALCULATIONS
I. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
7(�' � x.0125$ ��•�
(contract price) (mioimum$50.00)
2. STATESURCHARGE
��� '� x.0005 $ 2 '�
(contrac[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
pertnitted work including materials,labor,profit,and other fixed wsts. 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.
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.
Applicant's Signature: �•� Date: •!�
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DATE TIME ��
CITY OF ORONO CALLED IN �
INSPECTION NOTICE . scHe�u�e� =- �- �ic: i 1����—
PERMIT NO.���+�� �- �-� ��'� �, connP�Ere�
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ADDRESS �C��C:� �C�/ 1� --�-`�,�F �-��'
OWNER TELEPHONE NO. ` ��'( �
CONTRACTOR �`��'-���c�-� G �C ��'k�
� DESCRIPTION � �y�-Y l-�IC�GP �j--� �Y��;tr�--��~.�i
ty ❑ 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
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Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO
��., COMMENTS:
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W� ❑WORK SATISFACTORY:PROCEED�J` �/�• O PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ��'�'P�f,_�,^�❑ ��UE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION '/�/�/ TEMPORARY
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PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-460�
OwnerlContractor on site:
Inspector_ -- i�-
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DATE TIME '� �
CITY OF ORONO CALLED IN ��"
INSPECTION NOTICE SCHEDULED �'
PERMIT NO ,�?f� ' G6��3o'Z COMPLETED 3�
ADDRESS �rl�d I-Q�c G��p �� • r�3i•4,tc��r1
OWNER TELEPHONE NO.y�o� -�� _ys�
CONTRACTOR ����s��
� DESCRIPTION r'e'�'�s,0�c� ToS f��� st •.= �rS�-` �G✓
tL ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTf��NAL f' �'
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
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
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J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContractor on site:
Inspector: �� � '-" �
White Copyllnspector's File Canary CopylSite Notice
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CITY OF ORONO CALLED IN �- -��o
INSPECTION N TI E s HEDULED - - �3O
PERMIT NO. ��`$ MPLETE �_
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OWNER . TELE HON O.� 3 �'�'S7 �9d
CONTRACTOR
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� DESCRIPTION
t4 ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
�/�:.FJpIAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
4i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
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J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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� ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOfi �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 forthe next inspection 24 hours in advance. (g52) 249-46��
OwnerlContractor on site:
Inspector. � / �- �
White Copyllnspector's File Canary CopylSite Notice