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Home My WebLink About2012-01232 - gas fireplace CITY OF ORONO * 2 0 1 2 - 0 1 2 3 2 * , 2750 KELLEY PARKWAY DATE ISSUED: 12/12/2012 ' ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 REPRINTGD ON 12/12/2012 ADDRESS : 3925 CHERRY AVE PIN : 08-117-23-33-0086 LEGAL DESC : HICKORY HILL : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIREPLACE-GAS VALUATION : $ 1,200.00 NOTE: (1)CAS P'ACTORY C'IREPLACC -LENNOX -MODEL#'S MLDV"1�40 DOWNSTAIRS FIRGPLACE ONLY APPLICANT MECHANICAL 50.00 FERGUSON STATE SURCHARGE MECH (VALUATION) 0.60 925 DECATUR AVENUE GOLDEN VALLEY, MN 55427- TOTAL 50.60 (763)367-0317 PAID WITH CASH 50.60 OWNER Real Assets LLC 550 25TH AVE N ST CLOUD, MN 56301- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specitieations,applicable City approvals,and the State E3uilding Code. This permit is for only the work described and does not grant perniission for additional or related work which requires separate perniits. All provisions oflaws and ordinances goveming this type oCwork shall be compied with whether or not specified herein.This permit will ;xpire and become null and void if construction authorized is not commcnced within 180 days of the date of issuance,or if construction is suspcnded for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested ir�conformance with the State Building Code.This permit may be revoked�i,&ny time for due cause. ' ��.�1� ��i�/ �� l � � � � � Applicant Permitee Signa rc, Date �� — Iss By Signalure Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE. � � FO CIT USE ONLY ��3 �a--� —- ,�_` � ��'�`►�� ( Date Receive�� Permit# �v�� i �! ,, 2 0 P y �3 �p �.� �" 1 5 23 � � Approved By: Amount$: � � rA�,' �� ph 5 �60 a ��52)249-4616 , �� owd,' � = OF ORONO—MECHANICAL PERMIT 1 o e,�y�l rmits must bc approved by the Building Official or Inspector and/or Fire Marshall) G RA 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 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. 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 Q Residential ❑ Commercial(Approval Required) � New ❑Additionai ❑ Repairs ❑Replace Job Site / Owner Information: s�t� aadress: 3925 CHERRY AVENUE oWl,er: D EAN J O H N S O N Mailing Address: ci�: MEDINA zip: Home Phone: Alternate Phone: Contractor Information: Contractor: F E RG U S O N Contact Person: B I L L 925 DECATUR AVENUE M B003534 Address: State Bond#: GOLDEN VALLEY 55427 06/11/14 City: Zip: Expiration Date: phone: (763) 367-0317 Alternate Phone: (763) 591-5700 ❑ Insurance—Current: 1 S . . ' �� MECHANICAL SYSTEMS BEING INSTALLED Note: All Geothermal Systcros will now require a Site Plan& Review by our Building Of'cial. 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 0 Gas Factory Fireplace Brand Name: LENNOX �N ❑ Wood Burning Fireplace MLDVT40-� ❑ Wood Stove Model No.: ❑ 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 MarshaU if proposing to abandon tank in place.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside LP Gas: gallons Other: CAS 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 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 ontract price ith a(Minimum Fee of$50.00) G`� / ` ajd� X .o125 � (co�tract price) (minimum$50.00) 2. STATE SURCHARGE x .0005 $ (contract price) 3. POSTAGE&HANDLING (Only on Mail-ln 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 ar 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: � � � � Reset Form 3 C� DATE TIME ✓ CITYOFORONO CALLEDIN /Z-/2/2 INSPECTION NOTICE SCHEDULED /2 -Z-/2 PERMIT NO.��D/�'3� COMPLETED ADDRESS � OWNER TELEPH E NC�lo,3 '�✓�07�D�j`� CONTRACTOR `� I - � >; DESCRIPTION � W ❑ FOOTING ❑ PLUMBIN FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOH TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � � � GW ❑WORKSATISFACTORY:PROCEED �PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. • Call for the next inspection 24 hours irt advance. �95Z� Z49-4600 OwnerlContractor on site: Inspector. �V.��/.�� White Copyllnspector's File Canary CopylSite Notice