HomeMy WebLinkAbout2015-01306 - gas fireplace � • CITY OF ORONO * 2 0 1 5 - 0 1 3 0 6 *
2750 KELLEY PARKWAY DATE ISSUED: 10/08/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 4305 CHIPPEWA LA
PIN : 31-118-23-42-0011
LEGAL DESC : CHIPPEWA
: LOT 003 BLOCK 001
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 2,500.00
NOTE: (1)KOZY HEAT GAS FACTORY FIREPLACE
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.25
PRACTICAL SYSTEMS MAIL-IN FEE 2.00
4342B SHADY OAK RD
TOTAL 53.25
HOPKINS,MN 55343
(952)933-1868 Payment(s)
CREDIT CARD 3543 53.25
OWNER
CORNICK,JAMES& DEBRA
4305 CHIPPEWA LA
MAPLE PLA[N,MN 55359-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according[o
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 sepazate
permits. All provisions of laws and ordinances goveming 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 1 SO days of the date of issuance,or if construction is
suspended for a period of l80 days at any time after work has commenced.
The applican[is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Issued ignature Date
Cc t, 8, 201� 10 ; 34AM No, 4994 P, 2/4
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� USE OIl'LY � /��
��� Cify of OroAo ���, ��`. '�j'-
P.O.Sox 66 T33te.1tec permit# ,
0 2750 TCclley Pa�lcway ,��. �
Crystal Bay,MN 55323 APPro°ed�y: Amwnr$:,��_T
Pl�one(452)249�600 Fax(952)249-4616
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`� tiG� CITY OF ORONO—MECHAIVICAL PERMIT
t���S��� (All Commescial pe�mits mu5t be app�oved by the Building O�cizl�Inspector snd/er Fire Macsball)
GENERAL�NFORI�AT�ON
1. You may appiy foi mechanical permits by mail or in�erson at thC City offices_ ApplicaYioms will
be rcvicwcd and a peruiit will be issued within two worlciutg days.
2. Peraiit cards will bo sent by return mail a$eP a review is compleYed. pEKiKi�Il'TS ARE NOT
VAI,ID UNTTL YOU RECENE A PERI��IT_ WORK Mi1ST NOT�3EGX1V�JN'TYY�T�
p��L'V�T C_ARl)XS�OSTED ON THE JOS SITE.
3_ Mechanical Desi�s—Complete calcularions,d�tails and specifications are required for eack�
hea�g,vznti]adoz�,huznidification-dehumidification,and air condi�oning iastallatian xnclud'uag
hcat loss/heat gain caJcu�atzo�u,design tempeta[ures,equipmcnt ratings and identifrcation as to
type,manufacturer and mpdel- l�ata S�all be prescntcd on form provided_
4, '�Vhen any new conshuction or r�uaodeling is involved,a separate building p�rmit must be
obtaincd.
5. All r�ork must be done in accordance with the Lzzi:form Mer�hanieal Code/52ate�uilding Codc
requircinemts.
6. All work must be insgectod(rough-in and fAnal). Call(952)249-�b00.
(24�t8 hour nocice reqnired)
7_ �Iouse Heating Test�Z.ecard must be submitted before final_
TYPE OF PERMIT`
Check�111�'hst f� 1
I1��tesidentisl ❑Commerciai(,A►ppmvai�equired)
❑NeW �Additionai ❑�epaIis �eplace
rob Site/Owner Informarion:
siteAddress: � C�11PP�.1n1A LAN� -L1.R.._!..)1\IO,Mt�15�535'�
Owner:�Il��j G�,�,S'J���C,k Mailina Acldress: ��]
c��: ��, M�J z�p: �-r'a35q
Home Phone: �S)�7�_��y Altemate Phone:
Contr3ctor Information;
Contractor: PR,AGTIC.P�.�1lS'1�i�I5Coutact�erson:
Address: �.?��51��/ C���State$ozzd#: �Q�, ��Q
City: �Q�,1 NrJ Zip'S'S�y3Expiration 17ate� Q �
Phone: �q�j�.���3�19(,�,� Altexnate Phone:
❑ iusuzance—Clurent: '(H��UII�.R's �p�
1
Oct, 8. 2015 10: 35AM No, 4994 P, 3!4
����f �� ����4 �G��ly����?'��4�U,��+�"J!����r?u-'�J:�1J�! �� � .w � i���� a
Note:Al1 Geothermal Systems will now require a Site Plan&Re�vi�vv by ow�uildizxg Official,
IS THI5 G�OT�YtMAY,? ❑x es 1�No
�AT'TNG S'Y'ST�M5
���= � �
M�C: KQ�.y l�AT
Mo�r: CSk,-33�rS
Fuel: ('7�,�_
�1uc 5ize:
Znput BT'(7s: '�.�-��
Output BTUs_ �
CFM:
�OOLING SYSTEMS
Quausity:
Make:
Madel:
Tons:
�.Povver
FIREPLAC�S
(� Cas Factory Fircplac� �rand N'ame: ��� �,��
❑ Wood Buming Fireplace
❑ Wood Sto�e Model No.: �(���j�J�
❑ Wood Sto�e uvith FIuc/Masonry
VENTILATION
❑ No. Kitck�en,Exhaust duet recuculati�ug efim
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORACr� (1Kust Ge approved by Fire Marshall if,p►'o,posing A�abandon tank in pZace.)
❑ Installatzon ❑ Removal
�el bi1= gallons 0 Clndergraund ❑baside []Outside
LP Gas: gallons
Othcr:
GAS LINE O1VT��Y'
Q Outdoor Grila [] Othcr/Lis�Wlzat c�Where:
?
Oct, 8. 2015 10: 35AM No. 4994 P, 4/4
;,�� pr�;i � �����,1:�����..����'V���� ����i� �����""��w,g�i`9 �'f,� �'� � i'.��
�'r' ��' �"� 'BASED OFF���OO�:,STATE ST�,.�. ,< ��, -, , , �� , .,�.
❑ Yes,this section applies
Thc replacament of a Residential fixcw-e or aopliance that meets all thzee of tl�.e�ollowi.ng requirements�
I_ e t require znodi�ication to electrical or gas service_
2_ Has a tot c o�$500.00 or less;excludin�the cost of the fixture or appliance:and
3. Is improve�installod or rcpIaccd by thc homeo�mer or lieensed Coniraetor.
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 $
���''�'�'.�.G'lU�..Pi-�`x0�t S �.:�.`7�$�`;C�'��;�'�a0��0'0';;� . ', ';'G„ ' ''�'
If above does not apply;follow guidclincs beIow-:
1. CONTRACT PRICE *is 1.25%of cantracC price wirh a(lv�iaim�uioa Fee of$50.00)
�z,�oa.00 x.01�5$ 50.00
(conhact pnce) (mibitutun$50.00)
z. sTA'rE suRcx.�ItGE CMM nr
(�Z,:�IJlJ.4L� x.0005 $ �. !�"J
(coa�ract price)
3. pOSTAG�,&T-�AN17T,TNG(Only on Mail-Tn Ap�lzcations) $ 2.00
4. TOxAX.���'X'T��(Add�.i,nes 1-3 Above) $ CJ�•�•�
• * CON'Z'RACT PRIGE or lOB COST means the actual or estimated dollar amount chargcd for thc
pez�uitted wor�C u�cludiz�g z�aateriais;labor,profit,and other fixed costs_ it is the amount to be charged
to the customer fbr the work done. If any rr�atezial,eqwipnaent,labor or in,srailarions are fumished by
the owne�[,tezzant oz any othez party,the reasoIIable mark.et value of such ite�,s must be addcd to the
eSlxxx�ated cost or co��'act price for permtt fee purposes. In the event that there is a disput� on the
amount of the job cost,the City may zequest the submission of a sig�t�d copy of the actvaI conLtscC.
,
,
;�' '� ��';AsYJ° ���'°�����.�'�'��"�;�f:�'� '' .�+�- ' '� .'.
�'}ae undersxgaed hereby a��lies to the City far issuance of a Mechanical Permit,agrees to do a11
work in strict acco�rlance with the ordinances of the City and the regulations of the State of
Minnesot� and certifies rhat a1i sratemcnts rnade on this application are complete, true and
correct.
Applicant's Signature: Date: �(� Q
3
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D TE TIME
CITY OF ORONO CALLED IN /D oZ
INSPECTION OTICE SCHEDULED / .__�
PERMIT NO.��-s��.��� COMP ETED
ADDRESS ��S
OWNER T LEPHONE NO��07��'D1�S
CONTRACTOR �
i DESCRIPTION � � �� ��
W ❑ FOOTING ❑ DEMO- INAL ❑ 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
Q��NAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNER/CONTFiACTOR TO MEET YOU:_YES_NO
v�i COMMENTS: ��S i�irt e l�c•� �'+c5i-` /��laP.�� �
a �a ps� s.��� �a - a3 �i.� ��.---
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� ❑WORKSATISFACTORY:PROCEED /�vG �RgQJECT COMPLEfE �'C�/�C
W ❑CORRECT WORK&PROCEED �e ��u,�,( .� ❑ ISSUE CERTIFICATE OF OCCUPANCY C'f
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECWERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
11 for the next inspection 2a hours in advance. (g52) 249-4600
wn tractor on site: � �
Inspector. "^-
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