HomeMy WebLinkAbout1993-004960 - fireplace PERMIT . � . .
4 C�TY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 t{i.`-.�t�r'i�"I t��:�-
Permit Number: ;a�_;sg:_,;_,;:;
Crystal Bay, Minnesota 55323 Date Issued: - - � -�
(612) 473-7357 �-�''�;�?-�''a:`'
SITE ADDRESS:
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APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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CITY OF ORONO APPLICATION FOR MEC�IANICAL PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
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 2 working days.
2. Pemut cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PER1kHT. WORK MUST NOT BEGIN 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. Identification of and specifications for water heating equipment
shall also be 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 473-7357. 24-hour notice required.
7. House Heating Test Record must be submitted before final.
Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification. '
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 473-7357.
Please check one: �New Addition Repair Replace
� Residential Commercial
JOB SITE• �j�5 r� �T.4-� ,g� �d c:c�!' z.�r� Zip: S s�i/
Owner'sName: ,L� � �L�.��:i TelephoneNumber: 9.��-o ���
Mailing Address:,���3 c�y,�r-�� !��y /'� City: �,/�' z,��-� Zip: �5-53 9/
Contractor'sName:SE'�'�/�i�S �o�v S� TelephoneNumber: y7y��.�a
MailingAddress:�5��,���.�,��/��v� City: �%��,� Zip: 5 5�;�/
SYSTEM DESCRIPTION
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
� Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H. Power
�
WOOD BURNING EQUIPMENT
Wood stove with flue
Wood combination or add-on
�/ Factory fireplace with flue
� Factory Fireplace (s) � Freestanding Masonry
Wood Stove (s) Franklin, other
Brand Name {���T ,�/ G L�� Model No.
Mfgr's Min., Clearances, side� , rear , min. flue dia.
Total
VENTILATION
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. uiher Fans: i,uca�iu�� cf��
Total
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation Removal
� Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PERMIT FEE CALCULATION
l. 1.25% of Contract Price* or Minimum Fee ($35.00)
;�-'C . �'�= x 1.25 $
(contract price)
2. State Surcharge. ** Add the State Building Code Division
Surcharge to each permit. x .0005 $
(contract price)
3. Postage and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ �_%,��. � ��
* CONTRACT PRICE or JOB COST means the actual or estimated dollaz amount chazged for the permitted
work including materials, labor, profit, and other fixed costs. It is zhe amount to be char�ed tn the
customer for the work done. If any material, equipment, labor, or installation 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 pemut 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.
** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is
greater. For valuations over $1,000,000 call the Department of Inspectional Services for the price.
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 Minnesota
State Building Code, and certifies that all statements made on this application are complete, true
and correct.
Applicant's Signatur, . Cl�/' Date: -�'���- ��
�
Approved By: Date:
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