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Home My WebLink About2012-01106 - gas fireplace CITY OF ORONO * 2 �1 1 2 — 0 1 1 0 6 * 2750 KELLEY PARKWAY DATE �ssuED: 10/3U2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3025 CASCO POINT RD PIN : 20-ll 7-23-34-0002 LEGAL DESC : REG. LAND SURVEY NO. 0394 : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RES[DENT[AL CONSTRUCTION TYPE : FIREPLACE-GAS VALUATION : $ 4,000.00 NOTE: GAS FACTORY FIREPLACE-HEATH&GLO-MODGL ESCAPE I35 APPLICANT MECHANICAL 50.00 COUNTRYSIDE SERVICES STATE SURCHARGE MECH (VALUATION) 2.00 6511 HWY 12 MAPLE PLAIN, MN 55359 TOTAL 52.00 (763)479-1600 OWNER STANDA, SCOTT& IRENE 3025 CASCO POINT RD 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 Uic State Building Code. This permit is for only Ihe work described and does not grant pennission for additional or related work which requires separatc 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. Thc applicant is responsible for assuring all required inspec[ions are requested i conformance with[he State Building Code."i'his permit may bc revoked ny time,fo due cause. '� � fai 51 i � .2 _ l(7 �� Applicant Permitee Signature Date Iss e By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 4 - - FOR CITY USE ONLY City of Orono O¢O�O P.O.Box 66 Da[e Received: Permit# �. 2750 Kelley Parkway a "'�• +�' Crystal Bay,MN 55323 Approved By: Amount$: \� ��,r�"�,j to�� Phone(952)249-4600 Pax(952)249-4616 ��aro� CITY OF ORONO-MECHANICAL PERMIT (All('o�nmercial pennits must be approved by the Building Official or Inspector and/or Pire 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 Desi�ns—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 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 ) , �tesidential ❑Commercial(Approval Required) I ❑ New ❑Additional ❑Repairs �Replace Job Site/Owner Information: Site Address: �� ` I h�t �� Owner: �� S��'IC%lC� Mailing Address: ��'�'�- City: i '��c' LC-��r�'I Zip: -�1' �>�/ ( Home Phone: ��-� 7�-�`� 77 Alternate Phone: Contractor Information: Contractar: (,D� � �IG�Q ��ti/c�21 Contact Person: _G_,r!-1�� 'VI �'1 . Address: �J �� IY� ��-- State Bond#: /Y( ��0�''S�(.3 ry � L City: �� '► Zip:��yExpiration Date: �' � �G� � Phone: ��'�3 � ��/�� % �� Alternate Phone: �_ � Insurance-Current: �w� ��>�� 5`��-`�, 1 MECHANICAL SYSTEMS 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: Output BTUs: CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: H.Power FIREPLACES Gas Factory Fireplace Brand Name: �TQGF�� (��l,C� �] Wood Burning Fireplace - � �" ❑ Wood Stove Model No.: �SCLt G� .�3..7 ❑ Wood Stove with Flue/Masonry � VENTILATION ❑ Na 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 Marshal!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 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 reyuire 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 $ 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) �d��C. �� x .0125 $ -5 ��O 0 (contract price) (minimum$50.00) 2. STATE SURCHARGE /, a �l G'O'C' - � x .0005 $ o� (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �5��,e�� ■ * 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. 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. ° ,�p �.�� Applicant's Signature: � Date: Reset Form 3 CITY OF ORON� ��.�°'�E/�- TIME � CALLED IN INSPECTION N T�E �� SCHEDULED /�/� � PERMIT NO. MPLETED ADDRESS . J ,S C'�� X OWNER TEI.EPH E NO�� a //� CONTRACTOR C� >; DESCRIPTION � � � � ❑ FOOTING ❑ PLU ING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICALRI � LAKESHORENVETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIAEPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL ��NTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � W C j -�7 � f � � �-� � -f` �; �L 0 a � o �:'1� � �� `� i � � ,�„J 'f" W � � Q � z W � W � � d � ❑WORKSATISFACTORY:PROCEED �'PrROJECTCOMPLETE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-460� OwnerlContractor on site: , Inspector. f ,�/ '� � � White Copyllnspector's File Canary CopylSite Notice