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Home My WebLink About2015-00002 - gas fireplace , CITY OF ORONO * 2 0 1 5 - 0 0 0 PJ 2 * 2750 KELLEY PARKWAY DATE ISSUED: OUO2/2015 ORONO, MN 55356- 952) 249-4600 FAX: 952 249-4616 ADDRESS : 2760 COUNTRYSIDE DR W PIN : 04-117-23-]2-0011 LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN : LOT 003 BLOCK 002 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIREPLACE-GAS VALUATION : $ 2,661.75 NOTE: (l)HNG GAS FACTORY FIREPLACE APPLICANT MECHANICAL 50.00 STATE SURCHARGE MECH (VALUATION) 1.13 FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00 2700 FAIRVIEW AVE ROSEVILLE, MN 55113 TOTAL 53.13 (651)633-2561 Payment(s) Minnesota State License#: mech-20512060 CHECK 20051 10 53.13 OWNER STERN, JON& MOLLY 2760 COUNTRYSIDE DR W LONG LAKE, MN 55356 AGREEMENT AND SWORN STATEMENT "I�he work for which this permi[is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only[he work described and does not grant permission for additional or related 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 null and void if construction authorized is not commenced within 180 days of the da[e of issuance,or if construction is suspended for a period of l80 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. � i � i/S Applicant Permitee Signature Date ssue y Signature Date � FOR CTTY USE ONLY �O A TO City of Orono 1 y P O Box 66 Date Received: Permit# 2750 Kelley Parkway` Crystal Bay,MN 55323 Approved By: Amount$: Phone(952)249�4�i00 Fax(952)249-4616 a >, , SF ; ` `�KESH��G CITY OF ORONO�MECHANICAL PERMIT (All Commercial permits must be approved by the Building Ofticial or Inspecror and/or Fire Marshall) GENERAL INFORMATION L 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 BEG[N UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical DesiQns—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 ^ esidential ❑Commercia)(Approval Required) ❑ New ❑ Additional ❑ Repairs ep ace Job Site/Owner Information: Site Address: � �U� q � �'� � Owner: �11 S-�Q,-{Y� Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: Contact Person: H & HOME 'i��hi1�ULOGIE� Address: State Bond#: �� IRESIf]E HEARTH & HOME 6 2700 FAIRVIEW AVENUE N City: Zip: Expiration Date: ROSEVri i E, MN 55113 bS1.6.33.2561 Phone: Alternate Phone: ❑ Insurance—Current: 1 MECHANICAL SYSTEMS BEING INSTALLED Note: All Geothermal Systems will now require a Site Plan& Review by our Building Ofticial. 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: Wood Burning Fireplace ❑ Wood Stove Model No.: � �K—' �3 ❑ Wood Stove with Flue/Masonry VENTILATION ❑ Na Kitchen Exhaust duet recirculating cfm ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (Must be approved by Fire Marsha!!if proposing to abandon tank in p[ace.) ❑ 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 STATLTE ❑ Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: l. Does not require modification to electrical or gas 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 homeowner or licensed contractor. Skip next section, if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-[n 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) 2�-L l.(� � '� �x.0125 $ �� (contract price) (minimum$50.00) 2. STATE SURCHARGE �( ,^,l„�� '� x.0005 $ � . � � �-�'l.(� �price) 3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines I-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 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 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. ---_—_.�� .______._---- _ �Z �� ( � � Applicant's Signatur . ' Date: 3 -_.,,_- — ____ � DATE TIME r ► / CITY OF ORONO ``�� cALLED IN l INSPECTION NOTICE .� SCHEDULED I � � � PERMIT NO. � O(_��-�'��COMPLETED ADDRESS Z-7�c �� C �l�✓1`{-�'�Q j�_ �'(� V�° . OWNER TELEPHO� NO.�� '-'� �' �� CONTRACTOR �� 7� �� DESCRIPTION �j.��.7 ��e- � �C'��S t� ❑ FOOTING ❑ PLUMBING FINALj �`�� ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ��M1�ECH ICAL R�� ❑ LAKESHORE/WETLANDS Q ❑ FRAMING � MECHANICAL FINAL � � TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP p COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL ��.a�vlRml I ❑ SE C FINAL ❑ FOUNDATION/REMOVAL �" ' ----.. 2 OWNERICO CTOR TO MEET YOU: YES_NO � OMMENTS: � W a � J O � � r O � W � Q � 2 W � W � J W C� OR SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑C ECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑ FiECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOUERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. O PHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION IS D O STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 h in a . (952� 249-46�� OwnerlConVactor on site: Inspector. White Copyllnspector's File Canary CopyfSite Notice