HomeMy WebLinkAbout2011-01467 - gas fireplace �
�r CITY OF ORONO PERMIT NO.: 2011-01467
2750 KELLEY PARKWAY
ORONO, MN 5535C- DATE ISSUED: 1U22/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 930 COX FARM RD
PIN : 27-118-23-33-0013
LEGAL DESC : SHADOWOOD FARM
: LOT O10 BLOCK 001
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 4,000.00
NOTE: GAS FACTORY FIR�PLACE-PETGRSON-GAS LOG SL"1'
APPLICANT MECHANICAL 50.00
GLOWING HEARTH AND HOME STATE SURCHARGE MECH(VALUATION) 2.00
100 ELDORADO DRIVE
JORDAN,MN 55352 MAIL-IN FEE 2.00
(952)495-2927 TOTAL 54.00
PAID WITH CC# 9799
OWNER
KILL[NGSTAD, MR.& MRS.
930 COX FARM RD
LONG LAKE, MN 55356
AGREEMENT AND SWORN STATEMENT
I'he work for which this permit 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 the work described and does
not grant permission for additional or rela[ed work which requires separate
permits. All provisions of laws and ordinances governing this type of�work
shali be compied with whether or not specified herein.7'his permit will
expire and become null and void if construc[ion authorized is no[
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of l80 days at any time atter work has commenced.
The applicant is responsible for assuring all required inspec[ions are
requested in conformance with the State Building Code.This permit may be
revoked at any txne for du�e. _
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Applicant Permitee Signature Date � Issu By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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d��`"��� City of Urono � �, �, � ���
�0 I',U.i�ux 66 ��nw nceoivu• � ,,..�_ Pcrnijt�, L 1;
W�,�, 275U lCclluy Parkway
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� �� I'hrn»(952)249.46f10 I��is(952)'_4J•4ti l6 ,
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C1TY OF ORONO--l�/CEC$ANICAL PERM11
(au cmnmerciai permiis�nubi b�appru�rd by iF�c Liui►ding otTicial or luspec�orsnd/or fire MorshKlU
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1. You may apply 1'or mechanieal permits by mail or in person at thc�City offic�s. ApialiCaCi�ns will
be reviewed and a permic will bc issucd wichin iwo worlcin�days.
2. Permit curds will bo sent by return mail afie�•a review is wmplGtcd. PERMITS AR..E NO'I'
VAL(D UNTIL YOU ItECE,I V�A P�;121VI1'I'. WOIZK MUST NOT BEG1N UN7'iL THE
NI,RMI'I'CARD IS POST�,U ON TIHE�UOl3 S17'I's.
3. Mechanical Desicn�-C�omple[e calculations,deC�ils and specifications arc�re�quir�cl Fnr Gach
heating,vcnCilation,hwnidification-dehumidi�cation,And air conditioning inaC�11F�Ci;un ineluding ,
h�tt loss/heat gain calculatiun,de3i6n Ccm��erat�irc�s,equipment ratings Fu►d identific��ition as to
typc,m�nufacturer and model. Daco.shall t��pres�nl�d on form provided.
4. When ttny ncw construction or rc�n�odeling is ii�volvzd,t�snparaCn building pcm�il'niusC bi:
obtained.
S. All work must be done in�:curdance wir;h�hc Unilorm Mechanlca) Code/State Bui�ding Code
requiremcn�s.
6. All wa'lc must be inspdcWd(r�ugh-in and linal). Call(J52)249-4600.
(24-48 huur noticc ruqairod)
7. l•louse 1-lealing Test Record must be submilied beforc ltnal.
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'(C���c1�,�11.1Ii f���a��A,P�aIY)�; "�; , .:
�I�esidential ❑Comm�rcial(Approval Required)
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❑Now ❑Additi�nal ❑ Itepaics Rcpl:�cc
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Site Adclress: � Y��
Own�r: lVl�ailing Address: a13� Ci��l�C�� ��
City: l./1/'�l��'1 O Z�p: �S�i� ��
llome Phon�: Alcc;rnate Phune:
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Contractor: � �, ���'I�'�untacC l�erson: � '" `�-rl�•- � C� S�-1
Address: �(� ��C�K�d'��1�1�' State Bond#: `�� Q5�F; � c� I
City: ) lip:��r�xpiration Date: ��;;;�_1_�_L_�
PhonG: �����1�— ���'Lp AlternatePhone:
lnsurance--Current: I U�� — I b�.��'�
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Note: All Geoth�rmal Syslems will now reyuiu•e a Sifie Plan&Review by our Build�in�Ol''ficial,
lS 7'HIS GC01 HCItMAI.? ❑ Y�s ❑Ncy
1•ICATINC SYSTCNI5
Qua�itiiy:
Maka: --- . ...._T ..—�_...._— --....,,....__._. ...,,.,,.__�
Model:
F'uel: �._--------. _.__..._..__.,,-- —•---
l'lue Si2e:
Input I3't'us:
Output 13'I'Us:
CFM:
COOLING SYS1'GMS
Quantiiy�
Malca; „ ----... —�---------
ModeL•
Tons:
H,Power
Ell'tEl'LACL'�5
p oI�r
� Gas Faccory Pireplace BrandNam�: 'C.`'�"`V ;��
❑ Wood k3urning I'�ireplacc �i
❑ Wood Stuv� Model No.� - .��_�„���1��
❑ Wood Stove with l�lue/Masonry
VI�N'1'l l�ATIC)N
❑ No. l�itchen Exhaust_. duct rccirculating __ cfm
a No. .,_ Balh Exhausl'(mu�C htivc duct outside) _-_- �� - ���
Nu. ^ Other F'ans: Locations cfin
FUEL STORAGE (Must Ge upproved by Fire Marsh�ll lf p�upasinb•to ttbandun ta�k ln p.fac�.)
❑ Installation �] Removal '
huel Oil: __,.,_._�__g�Uluns ❑ Underground ❑ Insid� ❑ Outside
LP Gas: gallons
Olhdr:
CAS LINE ONLY
❑ Outdoor Crill ❑ Ott�er/LisC What&Where: .
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❑ Yus,this s�ction applies
''1''he raplacement of a ResidcnCir�l 1 ixture or�pplianc:e l'h�C mnets all thrc:c:of tho followinb rc,yuircmencs:
I. DoGs not require modification io electrical or gas serviec.
2. 1•las a otal eost of�500.00 or less;exc;ludini l•h�cost of the fixture or appliancr�:and
3. !s improved, installed or replaced by lhe homeowner ur liecnsed eontractoc.
Skip nexl secCion,if thi�applics; CosL of Permit $ . I 5.00
State Surcharg� $ , 5.00
Mail-In Fee(lf Applicable) $ , 2.00 �
1'otal Pormic Fee �
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11'abuve does no�apply;follow guidelines below:
1. CON'�fItAC'1'PRIC;L�. '� is 1?5%of contracc pricc with a(Minimurn i'nc ot;�SU.11U)
L f', , ['' x .o i?s� �;'�_
�Cunlruc;t prica) (minirt�wm�SU.UU)
?. S7'ATE SURCHARGE /_.` ���
_C;''(J�i U� x.00US :� c� , O �
(contrttcc pric�)
3. l>057'AG�6'c 1-IANDLWG(Unly on ��1.ail-!n Applications) � ,2,Q(1
4. TOTAL I'L�ItMl7'fLL(Add Lines 1-3 Above) $ ��; ��
� * CON1"12ACT YR10E or JOB COST m�ans th� actual or estimated dollar antount ;,harged for the
pccmitted work including materials, Iabor, proEit, Find oth�r fixed costs. Lt is thn.�noui�l to bc ehHrgcd
to the cuslomcr for tlie work done. If any maderial, equipmenl, labor or insCftllations bu'e furnished by
th�owndr,tonant or any other p�rry, Ihe[easonable marknt value of such items must �ic add�d to th�
estimated eost or contract price for permit feu purposes. !n the event chat there is a.dispute on the
xmount of the job cost, 1'he City may rcquesC I;hc submission of a signed copy of thC�ictutil contracC.
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The undersigned hereby applic�s to lhe Cily for issuaaice of a IVl�chanical Permit, �,.�;rees to do all
work in striet aeeordance with the ordinances of the City and the rogulations oE'the State of
Minnesota, �nd cerlif�s lhat all statements made on this applicatiun arz complete, true �nd
correct.
Applicant's Si�nAture: ---,, ��, -� Dat�: ! ( ��� �
w�y{������C��y�ip,�" ��:'��''�"�rb,�+�;,; �
I1��.�h.+.�inwi:�i��wr�� L6�iiL'�li
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DATE TIME� \
CITY OF ORONO CALLED IN / /
INSPECTION NOTICE SCHEDULED � /l���
PERMIT NO �`U� � co PLETED
ADDRESS ��
OWNER ELEP NE NO s ` �`7-�'/ �-�
CONTRACTO ���2��v `_
�: DESCRIPTION �L �o
�
ll� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI ❑ 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 ❑ COMPLAINT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
� ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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GW �ORK SATISFACTORY:PROCEED C-� PROJECT COMPLETE
� ❑CORRECT WORK 8 PROCEED �- ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITNIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46��
OwnerlContractor on site:
Inspector. ��
White Copyllnspector's File Canary CopylSite Notice