HomeMy WebLinkAbout2012-00060 - wood fireplace . . CITY OF ORO O PERMIT NO.: 2012-00060
2750 KELLEY PAR WAY
ORONO, MN 553 6- DATE ISSUED: OU30/2012
952 249-4600 FAX: 95 249-4616
ADDRESS : 4465 BAYSIDE RD
PIN : 06-117-23-21-0006
LEGAL DESC : JOHNSON WHEELER 1 ST ADDN i
: LOT 001 BLOCK 001 ��
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-WOOD
VALUATION : $ 1,700.00
NOTE: WOOD BURNING FIREPLACE-BRAND NAME-WBFP-MODEL-641 000
APPLICANT MECHAN[ AL 50.00
CARLSON, ROBERT
4465 BAYSIDE RD STATE SU CHARGE MECH (VALUATION) 0.85
MAPLE PLAIN, MN 55359- TOTAL 50.85
OWNER
CARLSON, ROBERT
4465 BAYSIDE RD
MAPLE PLAIN, MN 55359-
AGREEMEIYT AND SWORN STATEMENT
I'hc work tor which this permrt is issued shall be performed according to
the approved plans and specitications,applicable City approvals,and the
State�uilding Code. This permit is for only the work described and does
not grant permission for additional or tela[ed 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 nuU id if constraetion authorized is not
commenced within 180 days , the date of issuance,or if construction is
suspended f'o�a period of 180 days at any time after work has commenced.
The ap.�licant is responsibie for assuring all required inspections are
requested in conformance,with the�ate Building Code.This permit may be
re�oked at any time for due�cause:�
�, �r : ;-" .:- l 3 � l�1 � / ��� l a-
A�plic n�Pe' gn re Date
�'� �� Issu By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OT ER THAN DESCRIBED ABOVE.
' � FOR ITY E ONLY
,�` City of Orono -7
+ 4O`v P.O.Box 66 Date Received:/� ��m��t# �v� ol ' d���
�:�� � 2750 Keliey Parkway
a �'�'�E;r`'�: F Crystal Bay,MN 55323 Approved By: Amount$: �'
�t�����c.�o` Phone(952)249-4600 Fax(952)249-4616
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CITY OF ORONO —MECHA ICAL PERMIT
(All Commercial permi[s must be approved by the Building ficial or Inspector and/or Fire Marshall)
GENERAL INFORMATION �
1. You may apply for mechanical permits by mail or in erson at the City offices. Applications will
be reviewed and a permit will be issued within two rking days.
2. Permit cards will be sent by return mail after a revie is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WO MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SIT .
3. Mechanical Designs—Complete calculations, details and specifications are required for each
heating, venYilation,humidification-dehumidific�tion and air conditioning installation including
heat loss/heat gain calculation, design temperatures, quipment ratings and identification as to
type,manufacturer and model. Data shall be present d on form provided.
4. When any new construction or remodeling is involve ,a separate building pernut must be
obtained.
5. All work must be done in accordance with the Unifo Mechanical Code/State Building Code
requirements.
6. All work must be inspected(rough-in and final). Ca (952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitted befor final.
TYPE OF PE IT
(Check All That ply)
�Residential ❑ Commercial(Approval Required
❑ New ❑ Additional ❑ Re airs ❑ Replace
Job Site / Owner Information:
Site Address: �-�l � ; ��� �
��Ga--�� � Q.��I.S����^ � � '
Owner. � � Maili g Address: ✓���/1�-� ��l l<<�-
City: � ii't vf O Z��. � � �7 ��
Home Phone: Altern te Phone: �� � `�� � �� �
Contractor Information:
�
Contractor: o'uh �V C�nta t Person:
Address: State ond#: ( b � ��
� City: Zip: Expir ion Date: ���� �� �� �
Phone: ��c� !��(J "' V �� � A1te ate Phone:
❑ Insur ce— Current: ""S
1
a�,. ,. ..... ��'�CHANICAL SYSTEMS�.3�T�� .�, .'�'.�LLED �
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: ', �-�t l
Wood Burning Fireplace
Wood Stove Model No.: � �`� ' ��
�� �-1 � �,� f
❑ Wood Stove with Flue/Masonry
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.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
.
PERMIT FEE CALCLTL TION(S) �
BASED OFF - 2002 STA E STATUE
0 Yes,this section applies
The replacement of a Residential fixture or a.ppliance tha mee s all three of the following requirements:
1. Does not require modification to electrical r ga 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 ho eo er or licensed contractor.
Skip next section, if this applies; Cost of ernut $ 15.00
State Su charge $ 5.00
Mail-In ee(If Applicable) $ 2.00
Total P rmit Fee $
PERMIT����,��,,;�� ;ULATION(S) � JOBS�OVER $54�0.00 ��� '� ,�'" �,.
If above does not apply; follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract p ce with a(Minimum Fee of$50.00)
` �C�" r x.0125 $
(contract pric ) (minimum$50.00)
2. S'I'ATE StiRCHARGE
x.0005 �
(contract pric )
3. POSTAGE&HANDLING(Only on Mail-I�Ap lications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
■ * CONTRACT PRICE or JOB COST means the actua or estimated dollar amount charged for the
pernutted work including materials, labor, profit, and ot er fixed costs. It is the amount to be charged
to the customer for the wark done. If any material, equ' ment, labor or installations are furnished by
the owner, tenant or any other party, the reasonable ma et value of such items must be added to the
estimated cost or contract price for permit fee purpose . In the event that there is a dispute on the
amount of the job cost, the City may request the submi sion of a signed copy of the actual contract.
°�' ` ��'°' R CHANICAL PERMIT APPLIC ���'�3�;�GREEMENT
�.. �.
; � � . .. ,. � �
The undersigned hereby applies to the City for issuanc of a Mechanical Permit, agrees to do all
wark in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements mad�'on this application are complete, true and
correct.
� � ���
/�
,,,:, �, a a_ ��r�
Applicant's Signature: Date:
..-.�,':
3
i I
�� ��� AT ' TIME �
CITY OF ORONO CALLED IN �' I�
INSPECTION NOTICE SCHEDULED ' :� ��
PERMIT N0. :�L�I� —GCC'k%C COMPLETED
ADDRESS �--�tD � � S\ '
OWNER �',�, C����i'iv�'rTELEPHONE Nb. � - 1 ' 7 I
CONTRACTOR �-V �'
�
�; DESCRIPTION
�
� ❑ FOOTING ❑ PLUMBING FINAL y'�jL��b�,iY� '�AV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LA ESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL '�] TR E REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE I] SI INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP
�] PR GRESS
� ❑ FINAL ❑ SEWER HOOK-UP [� CO PLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT.
�] FO OW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL C�] HA COVER REMOVAL
<�\,C7�Pt�G RI ❑ SE�FINAL [� FOU DATION/REMOVAL
OWNERICO TRACTORTOMEETYOU: YES_NO
� COMMENTS: y
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2
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� ❑WORK SATISFACTORY:PROCEED �GROJECT CO�IPLE �
W �CORRECT WORK&PROCEED ❑ ISSUE CERTIF`CATE F OCCUPANCY
O ❑CORRECT WORK,CAIL FOR REINSPECTION TEtWIPOR RY
V BEFORECOVERING PEF�MAN NT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �; pHOTOTAKEN'
INSPECTOR WILL RETURN
❑STOP ORDEF POSTED.CALL INSPECTOR � CITATION ISSU�D �I
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 2 9-46��
OwnerlContractor on site:
Inspector. I�
White Copyllnspector's File Canary CopylSite I�otice '
� �i