HomeMy WebLinkAbout2016-00540 - gas fireplace CITY OF ORONO �c Z 0 1 6 — 0 PJ 5 4 P1 *
. � 2750 KELLEY PARKWAY DATE ISSUED: OS/18/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1629 BOHNS POINT RD
PIN : ]7-117-23-11-0005
LEGAL DESC : REG. LAND SURVEY NO. 0565
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 4,000.00
NOTE: 2 GAS FIRPLACE/HEAT&GLO SUPREME-I30-C/ KOZY HEAT CSK-25
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 2.00
GLOWING HEARTH AND HOME MAIL-IN FEE 2.00
100 ELDORADO DRIVE TOTAL 54.00
JORDAN, MN 55352
(952)495-2927 Payment(s)
CHECK 23048 54.00
OWNER
AMPLATZ, CAROLINE
345 LEAF ST
P.O. BOX 619
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvais,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 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 1 SO 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 aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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pplic n ermitee ignature Date Is ued Signature Date
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ROR CITY L'SE ONLY
�O .iO City of Orono
1� P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By: Amount$:
Phone(952)249-4600 Fax(952)249-4616
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t�k£SH���� CITY OF ORONO- MECHANICAL PERMIT
(All Commercial perniits must be approved by the E3uilding 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 per►nit 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 RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desi�ns—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 ou form provided.
4. When any new construction or remodeling is involved, a separate building permit must be
obtained.
5. All wark 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) [Backflow Device: ❑ AVB ❑ PVB]
❑ New Additional ❑ Repairs ❑ Replace
Job Site / Owner Information:
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Site Address: ��� �
Ol�n� r j�= � ,,
er` �(�,' _ ��C.-�U�-'�� Mailing Address: �� �� �
Cit
Y �C.F�f'�� C�-- Zip: �s�� �
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Home Phone: ��;�" 7�� ��U��� Alternate Phone:
Contractor Information:
Contractor: � �«'l � '���f 1;�(.�Contact Person: ��� ����%�---
�M � /�
Address: �(�Z� ('i1 G C� l� State Bond #: Y' `��S I ��
City: �1pV� ^� Zip:�35�-Expiration Date: '� � � b
Phone: `'1��- 4Ct,r�- ��° ��� Alternate Phone:
Insurance —Current: �� 2 �" ��J 2- � (�
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t 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 �L ��
� Gas Factory FireplaceC�� Brand Name: �, �
❑ Wood Burning Fireplace / -.�
❑ Wood Stove Model No.: �-�IE�l'��"' r ' C,._ ;�S
❑ Wood Stove with Flue/Masonry L'.
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfin
FUEL STORAGE (Must be approved by Fire Marsha/1 ifproposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
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PERMIT FEE CALCULATIONS
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
( ��r�� x .0125 $ .XJ ' �0
(contract price) (minimum$50.00)
2. STATE SURCHARGE
��� �v� X .000S $ a� c�
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Abovel �_,���
■ * 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 state ents made on this ap lication are complete,true and correct.
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Applicant's Signature: `" Date: 5 I�
3
DATE TIMEI/
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO.`��G �db-��fUCOMPLETED �
ADDRESS_ ��f���tS �- ��O-
OWNER TELEPHONE NO.
CONTRACTOR �� `��-'� -���� �`"'�'�'
� DESCRIPTION O� '�'����� ���4�5
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
��FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 O'WNERICONTIUCTOR TO MEEf YiOU:_YES_NO
� COMMENTS: ,
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� ❑WORK SATISFACTORY:PROCEED �iOJECT COMPLEfE
W ❑CORRECT WORK 3 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CONERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p p�{OTO TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 2a hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector:
Whits Copyllnspector's File Canary CopylSite Notice