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Home My WebLink About2009-00855 - fireplace � � CITY OF ORONO PERMIT NO.: 2009-00855 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUEn: 1U30/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 175 CRYSTAL CREEK RD PIN : 33-118-23-33-0006 LEGAL DESC : CRYSTAL CREEK : LOT 005 BLOCK 001 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : FIREPLACE- WOOD VALUATION : $ 1,500.00 NOTE: WOOD BURNING FIREPLACE-BRAND NAME-HEATILATOR APPLICANT MECHANICAL 50.00 INTEGR[TY DESIGN&CONSTRUCTION INC STATE SURCHARGE MECH(VALUAT[ON) 0.75 21140 HONEYCOMB PATH TOTAL 50.75 LAKEVILLE, MN 55044- (952)985-5004 PAID WITH CC# 9899 Minnesota State License#: 20004064 OWNER ENGEBRETON,ANDREW& SALLY 175 CRYSTAL CREEK RD LONG LAKE, MN 55356 AGREEMENT A1vD SWORN STATEMENT Thc work for which this permit is issued shall be performed according to [he 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. Ali provisions of laws and ordinances govcrning this type of work shali be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within I 80 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 alI required inspections are q ested in conformance with the State Building Code.This permit may be o�ed at any[ime for due cause. --� 11 � 3� , D� � � Applicant P mitee Signature Date Issued E3y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. . , FO CIT USE ONLY ,�0�, City of Orono � /� O# O P.O.Box 66 Date Received: �0 Permit# �dD�` v� �;;,; 2750 Kelley Parkway c' � ��"�'�`-�. F Crystal Bay,MN 55323 Approved By: Amount$: J�� 14 � � ��.o` (952)249-4600 �'�tc�Hoa4' CITY OF ORONO -MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official or Inspecror 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. Perniit cards will be sent by return mail after a review is completed. PERIVIITS ARE NOT VALID UIvTIL YOU RECEIVE 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, ventilarion,humidification-dehumidification, and air conditioning installation including heat loss/heat gain calcularion, design temperatures, equipment ratings and identificarion 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 Heatin�Test Record must be subnutted before final. C TYPE OF PERMIT (Check All That Apply) � Residential ❑ Commercial(Approval Required) ❑ New ❑ Additional ❑ Repairs ❑ Replace Job Site/ Owner Information: Site Address: �7 S (�r��5'�C1 I l.(�LQ�' ��G�� Owner: `h i'`+Q�-S �Vl Mailing Address: Ch S'�� `Q�L' `�0�, City: �1-��o Zip: SS�2� Home Phone: Alternate Phone: �� -7� �� Contractor Information: � Contractor: � F �� Ch��Contact Person: '��d Address: �2�� I`4Q�E' �li ��'1 State Bond #: 2(�`�O �'��- City: �F11��'��(�� Zip:S 1 G{,I-� Expiration Date: �' �( ��2C( o Phone: �I�� -�'�-1-i G�G�Z Alternate Phone: [� Insurance- Current: �� ^'�(� ��r �U'��U � 1 . + MECHANICAL SYSTEMS BEING 1NSTALLED �'� 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 ❑ Gas Factory Fireplace Brand Name: I�c(rt��1 I(��j,F � Wood Burning Fireplace Wood Stove Model No.: ❑ Wood Stove With Flue VENTTLATION ❑ No. Kitchen Exhaust duct recirculating cfin ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (Must be app��oved by Fire Mai•shal[if proposing to abandon tank i�z place.) ❑ Installation ❑ Removal Fue] Oil: gallons ❑ Underground ❑ Inside ❑ Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoar Grill ❑ Other/List What R Where: 2 r � PERMIT FEE CALCULATION(S) � BASED OFF - 2002 STATE STATUE ❑ Yes,this section applies The replacement of a Residential fixture or appliance 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 $ .50 Mail-In 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 PWCE * is 1.25%of contract price with a(Minimum Fee of$50.00) � ; J �� x .0125 $ (contract price) (minimum$50.00) 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50) x .0005 � (contract price) (minimum$ .50) 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 matenals, 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. ■ **The STATE SURCHARGE is .0005 of the Building Department at(952)249-4600 for the price. � M�ECHANICAL PERMIT APPLICATION AGREEMENT '�, The undersigned hereby a lies to the City for issuance of a Mechanical Permit, agrees to do all work in strict accordanc��th 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. ; i 1 \ O'� s \ � Applicant's Signature: � .' �, /�� Date: � � � � � I V � 3