HomeMy WebLinkAbout1999-011844 - lennox fire place .,,�'� PERMIT
� OF ORONO PERMIT TYPE:
�i�U Kelley Parkway - P.O. Box 66 ;- -_ .-;�+;;•;T::f�-��!_
Crystal �ay, Minnesota 55323 Permit Number: : - �_ a s
(612) 249-4600 Date Issued: `-'� s``'�'�
'_f:''? _�_"%�'�_.
SITE ADDRESS:
::i;;��t�� ���3'�'��I;l�:�� 4�'.E�;
— ��—� S�` =�a��tt'L�';`
DESCRIPTION:
�=r=;_:::::_?-�°`r� �'I i=:` ' �...>:.i�:�.
_ �j;;��—;�;_T;t�i� !'fi-��'��.c:._ ?_;vi�;��_�.�.
REMARKS:
FEE SUMMARY:
�i i_'. f
-;;a.'.a:� #'�`._ =r•:'_���. . _ _ �'{?-i�; �!'+� � .'� _.._.....w_.__ .s:.�:..�.`::.t
=�1..i't'=_'�',a:l"!�'y` __—__._._.._—`:'' _ _ {i,t�„�j =�r� �';sfv�:-; , i�i_�
'_��_f=i T.E�='..�, i ��� '��
CONTRACTOR: _.. - __ OWNER:
""_. ..__._•}'•. �' �\��•L_i"!t.._�� _�f'T�_._.. M .. ; . _ _ ....,,�.f . ., . .. . . SI'. _�.
`�� w- --_.'�ti'.i _� � ',1 �::`-;+`>:-'}.ri;-� . ._.
it •_
-- -.-�:� �_ . _� � . .. = -._ __ .�� i°k'� . - -
v} ��'=::-: � ,�.� is - �- : ��'�- ' ; !f! -G;; -i�;�--;°,�—
: • .__ �.�:���:,_. ` �: :``� . _ . __ _. _ .. _ . . _ .. _., . ... . ._� _ . . . _ . ._ ._... . _.
� •� �:� � �
= :
... .�.. .�..... .�.. f . l • � { v ^;s r�4..: '� �:t%�i
�.^ Y.+�T;.....� .�.Y �. � _..,� . � .
�..L�u":` � ,_ . ,_: � +�� ,'` '�- t i,! ._ _. . ..,_._ !:;�_".?�•. �'s m . =.`i_. _� l _ _.. .. .__' '-1 t: ..». ;i!.�. }� � S s R..f.�
�F�;
:i ..__ _. _�_ . . ._.. ._......� . ._._ _ _ . . _.
. : t. . . r ,
L i~�`-;E4f`ui_: : ;f:":J1 ?`.:k�.;:i._ .._ . .. i� _ . . . . .... F_ � ';.f4� _._ _ . ,- __ :1...._:i�;:P�_ _ _ _,r- -�.._`�, ..� ._ �_ . . � . I
_.. _ ._. J
`��� \
G�,'�/� � /i`�' Y (
APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
� C J �_
; � � �
" - • � Viereck Fireplace Sales Inc. �
, � � : � , -
� 16151 Ma.inAvenue S.E. • Prior Lake, MN 55372 �-- -� ''
(612) 440-5620 / 440-5627 FAX � �� � �`S�
Coniractor Safes C���l
� �f�f a , nvoice # 3 618
CONTRA R' � PHONE �j AT
9�� `" / � / , �3
STREET JOB NAME ��
CITY,STATE AND ZIP CODE LOCATION ��!� %�,,, I
v �J�ti �
INSPE TION: CUSTOMER TO CALL PERMIT#: SUPERI DENT/MOBILE#! # .�OB HONE
YES : NO YES NO
' � Gas: Natural �� L.P. ❑ j � l c�
Venting: Top � Rear ❑ �
� ��� �� �- ���:�. .
� S�ding
Gas Fireplace Model: ✓J�
3 � � �
� � �a ��
Options:
��.�
�
� 3�
3 �
Options: �1.� 6
DIRECTIONS:
��'�'` i
V v
�
ITEMS NEEDED STARTUP: � LOCK BOX
' r
. ��'��
ACCEPTANCE OF PROPOSAL The above prices,speafications and /
conditions are satisfactory and are hereby accepted.You are authorized to do the �/,�Q�
work as spedfied.Payment will be made as outlined above.Service charge 1.50° Si ature �
on balance after 30 days.
� �
►� /Y� _ Signatur�
\N r
Date of Acceptanc8:
MODEL # SERIAL# INSTALL DATE
� �. .
�
CITY OF ORONO APPLICATIUN FOR MECHAIVICAL PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for mechanical pernuts by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within 2 working days.
2. Pernut 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 Designs - 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. Identification of and specifications for water heating equipment
shall also be 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 473-7357. 24-hour notice required.
7. House Heating Test Record must be submitted before final.
Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification.
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 473-7357.
Please check one: ^ New Addition Repair Replace
< Residential Commercial
JOB SITE: �'7�v ������ � Zip:
Owner's Name: `��p;� ya�A,� _ Telephone Number:
Mailing Address: City: Zip:
Contractor's Name: E A�� ��. Telephone Number:
�`iCi \AAIA1 A\/�_
Mailing Address: PRIOR LAKE, MN 553T2 City: Zip:
SYSTEM DESCRIPTION
HEATING SYSTEMS
Quantity:
Make:
Model:
FueL•
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H. Power �
. . �� •
f ,
WOOD BURNING EOUIPMENT
Wood stove with flue
Wood combination or add-on
� �� Factory fireplace with flue
Factory Fireplace (s) Freestanding Masonry
Wood Stoy;� (s) Franklin, other
Brand Name -�-��t,�,�-,�'� �,4`��� Model No. !-S��✓ ��-;�t�3.�-
Mfgr's Min., Clearances, side .-.--.�,- rear �_ �� —, min. flue dia. 7-� ,.�,�
,� "c.:Le-arr-���.�
:
VENTILATION ..�-� • ".s:�-c�.F,�,v-��
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. Other Fans: Locations cfm
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation Removal
Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
s /��_ e`�� X .oi2s $ l� �/ ��
(contract price)
2. State Surchar� ** Add the State Building�code Division S_,7
Surcharge to each permit. �j S� � x .0005 $ �6
or $.50, whichever is greater (contract price)
3. Postage and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ � �b�f�
* 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 installation are fumished 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 tne submission or'a signeci copy of the actual contract.
** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is
greater. For valuations over $1,000,000 call the Department of Inspectional Services for the price.
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 Minnesota
State Building Code, and e ifies that all stateme made on this application are complete, true
and correct. �
,
Applicant's Signature: �� � � Date: ���
Approved By: Date: