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Home My WebLink About2012-01141 - gas fireplace � � - CITY OF ORONO * z 0 1 2 - 0 1 1 4 1 * 2750 KELLEY PARKWAY DATE ISSUED: 1U08/2012 � ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1755 CONCORDIA ST PIN : 17-117-23-22-0018 LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK : LOT 012 BLOCK 000 PERMIT TYPE : MECHANICAL(> $500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIREPLACE-GAS VALUATION : $ 3,000.00 NOTE: I IEA"I II,ATOR ND130C GAS FIREPLACE APPLICANT MECHAN ICAL 50.00 FIRESIDE HEARTH & HOME STATE SURCHARGE MECH (VALUATION) 1.50 2700 FAIRVIEW AVE ROSEVILLE, MN 55113 MA[L-IN FEE 2.00 (651)633-2561 TOTAL 53.50 Minnesota State License#: 20512060 OWNER KOHRS, DOUGLAS (755 CONCORDIA ST WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT ��he work fbr which this permit is issued shall bc performed according to the approved plans and specifications,applicable City approvals,and the State[3uilding Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate 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 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. The applicant 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� \l� � / / / / Applicant Permitee Signature Dale Issued Bv S� ature D te SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. � � w FOR CITY USE ONLY ��,;¢p�� City of Orono /O O\ P.O.Box 66 Date Received: Pertnit# 2750 Kelley Pazkway t,� n`'x• �I Crystal Bay,MN 55323 Approved By: Amount$: �� '�� '��y�i� Phone(952)249-4600 Fax(952)249-A616 �n�: CITY OF ORONO-MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL INFORMATION 1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED OPT THE JOB SITE. 3. Mechanical Desiens—Complete calculations,details and specifications are required for each � heating,ventilation,humidification-dehumidification,and air conditioning installation including heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to type,manufacturer and model. Data shall be presented on form provided. 4. When any new construction or remodeling is involved,a separate building permit must be obtained. 5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code requirements. 6. All work must be inspected(rough-in and final). Call(952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before final. TYPE OF PERMIT Check All That A 1 �Residential ❑Commercial(Approval Required) �New ❑Additional ❑Repairs ❑ Replace Job Site/Owner Information: Site Address: I 7 S S Co n c o �r�', � ,S �- . Owner: � �`�'J (`�� 0 4-0!'� Mailing Address: � "�5S' Con co�Gf?�. s�-. City: �'S I'�+ r1 o Zip: SS`/?/ Home Phone: �Jsa-��(n - o?$�� Alternate Phone: Contractor Information: tiEARTH & HOME TECHNOLOGIES, ING. Contractor: Contact Person: RESIDE HEARTH & HOME Lic. BCO 060 Address: State Bond#: 2700 FAIRVIEW AVENUE N R 55113 City: Zip: Expiration Date: 651.633.2561 Phone: Alternate Phone: ❑ Insurance-Current: 1 r � � MECHANICAL SYSTEMS BEING INSTALLED 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: u C�+�:�At o � ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: � n T 30 'G ❑ Wood Stove with Flue/Masonry VENTILATION ❑ No. Kitchen Exhaust duct reciroulating cfin ❑ No. Bath E�chaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfin FUEL STORAGE (Must be appraved by Fire Marshall iJproposing to abandon tank in place.) ❑ [nstallation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ Inside ❑Outside LP Gas: gailons Other. GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List What&Where: 2 s �►- Y 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. Dces not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less;excludine 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) 3��` V� x A125 $ sQ•[J� (contract price) (minimum$50.00) 2. STATE SURCHARGE 3�. vti X.00as $ r. so (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 5,3.�v ■ * 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 perrr►it 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 Staxe of Minnesota, and certifies that all statements made on this application are complete, true and conect. Applicant's Signature: ��(.. �� Date: // / 2 Reset Form 3 � J TE TIME ✓ CITY OF ORONO CALLED IN � � �I Z INSPECTION NOTICE ' scHEou�E� II-�_/� � PERMIT NO. �—�� COMPLETED — � ADDRESS � 7.�� - `�- OWNER • ELEP NE NO. ��^3 � �g�S CONTRACTOR � °� >; DESCRIPTION � �- � �� ❑ FOOTING ❑ P MBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ 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 J ❑ P I ❑ SEPTI FINAL ❑ FOUNDATION/REMOVAL � O NER/CONT CTOR TO MEET YOU: YES_NO � C MMENTS: � W a � � • O . � �. � � � � O / f� �� tu . Q �-� � , � � � �/� � �� -� ' } ' '��/� � W � � � � �ORKSATISFACTORY:PROCEED �PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REOUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-4600 Owner/Contractor on site: Inspector. _ r l I � �� White Copyllnspector's File Canary CopylSite Notice