HomeMy WebLinkAbout2016-00201 - Gas fireplace CITY OF ORONO * z 0 1 6 - 0 0 2 0 1 *
2750 KELLEY PARKWAY DATE ISSUED: 02/29/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1380 BRIAR ST
PII� : 10-117-23-31-0053
LEGAL DESC : MARKVILLE
: LOT 000 BLOCK 002
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUAT[ON : $ 1,500.00
NOTE: SUPERIOR GAS FIREPLACE
APPLICANT MECHANICAL 50.00
STATE SURCI-IARGE MECH(VALUATION) 0.75
HAGEN FIREPLACE SOLUTIONS TOTAL 50.75
435 FAIRVIEW AVE N
LJNIT 2 Payment(s)
ST PAUL, MN 55104- CHECK 2443 50.75
(612) 839-7595
Minnesota State License#: mech-MB680260
OWNER
ZITZLOFF,JEFFREY& BRENDA
1380 BRIAR ST
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 approvals,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 l80 days of the date of issuance,or if construction is
suspended for a period of I 80 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.
/ /
Applicant Permitee Signature Date Issued By Signature Date
�` CITY OF ORONO * 2 0 1 6 - 0 0 z 0 1 *
' 2750 KELLEY PARKWAY DATE ISSUED: 02/29/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1380 BRIAR ST
PIN : 10-117-23-31-0053
;�;: . �� ,� �,eM
LEGAL DESC : MARKVILLE �.-
"d�r ;�$t#�i.�
: LOT 000 BLOCK 002
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 1,500.00
NOTE: SUPERIOR GAS FIREPLACE
APPL[CANT MEC NICAL 50.00
ST E SURCHARGE MECH(VALUATION) 0.75
HAGEN FIREPLACE SOLUTIONS TOTAL 50.75
435 FAIRVIEW AVE N
UNIT 2 ayment(s)
ST PAUL,MN 55104 CHECK 2443 50.75
(612) 839-7595
Minnesota State License#: mech-MB680260
OWNER
SUMMIT, R. RS.
1380 BRIA �� � ��
WAY A, 91- I� '�� �
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AGREEMENT AND SWORN ATEMENT
The work for which this permit is issued shall performed according ro
the approved plans and specifications,applic e Ciry approvals,and the
State Building Code. This permit is for onl he work described and does
not grant permission for additional or rela work which requires separate
permits. All provisions of laws and ordi nces 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 l80 days of Ihe 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. �1
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pplicant Permitee Signature ate Issued By Signature Date
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� • t,� FOR TY USE ONLY
�Q_A'� City of Orono , . 1 � � (�. �
<V� P.O.[3ox 66 Date Received: 2�r ��Permit# ��'��" ' �� �_
2750 Kelley Parkway � �'"
Crystal l3ay,MN 55323 Approved By: �� Amount$: ��p; • '�
Phone(952)249-4600 f�ax(952)249-4616
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��.�K�SF�o���' CITY OF ORONO—MECHANICAL PERMIT
��� (All(:ommercial�ermits must bc approved by the Duilding 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 return 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 ON THE JOB SITE.
3. Mechanieal Desi�ns—Complete calculations,details and specifications are required for each
heating,ventilation,humiditication-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 Apply)
��Residential ❑Commercial(Approval Required)
[�;New ❑ Additional ❑ Repairs ❑Replace
Job Site/Owner Information:
Site Address: � -��� '� � ��t �� t
Owner: S��'� ���'���� Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: ��� � � � ��e��C� � Contact Person: ���
" ����l��fi���
Address: ��ti� ��--� �V t c'w State Bond#: i�f� G��dU �(�U
City: �'�U Zip: Expiration Date: :='�� p ��� �
Phone: Alternate Phone:
❑ Insurance—Current:
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.: MECHA:NICAL SYSTEMS BEING INSTA�L `
Note: All Geothennal 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: ��!����� ��
Wood Burning Fireplace C��
❑ Wood Stove Model No.: �� � ��.�7'
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by Fire Murshu/!if proposirrg to abundon tank in p[ace.)
❑ 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 CALCULATION(S) >•
BASED OFF -2002 STATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture or a�pliance that meets all three of the following requirements:
1. 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-In Fee(If Applicable) $ 2.00
Total Permit Fee $
PERMIT FEE CALCLJLATION(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$50.00)
C��1
` .a.'`�� X .012$ $
(contract price) (minimum$50.00)
2. STATESURCHARGE
x .0005 $
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 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.
-=- MECHAIVICAL 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.
(� n ` n �
Applicant's Signature: "�'V v y�.�.— Date:�V�?�r'�-�
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CITY OF ORONO � CALLED IN �` �-- � ' ��
INSPECTION NOTICE SCHEDULED -;� '2,��/(r :
PERMIT NO. ' ���-� coMP�erE�
ADDRESS � ��'� �����C /� ���
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OWNER TELEPHON NO.��,� r��� �a
CONTRACTOR � r (�
� DESCRIPTION /`/ �"��� �/f
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL r
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
❑ DEMO-SITE ❑.$ PTIC INSTALL �
J �� OWNERICONTRACTOR TO MEET YOU: YES_NO ( ,� ��/�1
��� � ��. �y
� COMMENTS: -�"
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W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
C��T WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECWERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952) 249-460�
OwnerlContractor on site:
Inspector. - �.� ,
White Copyllnspector's File Canary CopyfSfte Notiee