HomeMy WebLinkAbout2004-P07943 - gas fireplace PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 P07943
Crystal Bay, Minnesota 55323 Permit Type: Me�hanicai Pe�its
(952) 249-4600 Date Issued: 9ila�2ooa
SITE ADDRESS: 65 Cygnet Pl
L.ong Lake,MN 55356
PID: 04-117-23-22-0008
DESCRIPTION:
Proposed Use: Residential
Pernut Class: General
Permit Type: Mechanical Permits Permit Sub-type(s): Gas Fireplace
DETAILS:
Approved per resolution#:
Separate pemuts required:
NOTICES/REMARKS:
FEE SUMMARY: PernutFee: $ 49.80 Valuation: $ 3,984.00
State Surcharge Fee: $ 1.99
TOTAL FEE: $ 51.79
APPLICANT: Countryside Heating&Cooling OWNER: Kevin&Michelle Krokzyk
6511 Hwy 12 65 Cygnet Pl
Maple Plain,MN 55359 Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
%��-�1�2�z� � �� �� ���`�:
APPLICANT PERMITEE SIGNATURE ISSUE Y SIGNATURB
Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for mechanical permits by mail ar 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 RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Designs - Coinplete calculations, details and specifications are required for each
heating, ventilation,humidification-dehumidification, and air conditioning installation
including heat loss/heat gain calculation, design teinperatures, equipment ratings and
identitication 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 (952) 249-4600. 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 (952) 249-4600.
Please check one: New � Addition Repair Replace
Residential �ommercial
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JOB SITE. .���� `�C;7�C�� / L.��-�=f Zip: �� j s�
O�vner's Name: � ��.-L Z- �� Phone Number:(�l� -7S�3��(ca,S�—'"
Mailing Address: �;� � L/�-C''�` �t�n'C'� City: ���J Zip: ,��5
Contractor's Name: � '�� ���—_ Phone Number: 7�� ��jS�� GL•
Mailing Address: ��5 l� / ��9 ��-- City: _��<�''ll-�-l!-�,�ip: ,��S�
SYSTEM DESCRIPT[ON
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
Wood burning factory fireplace with flue
Wood Stove
Wood stove with flue
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Brand Name � L'4T � �'� Model No. (p����'��k-"
0(��S .3i �3
VENT[LATION
Na Kitchen Exhaust duct recalculating cfm
No. Bath Exhaust(must have duct outside) cfm
No. Other Fans: Locations cfm
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation or Removal
Fuel oil: gallons underground inside or outside
LP Gas: gallons
Other Gas opening
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PERM[T FEE CALCULATION(S)
2002 State Statute Yes This Section Applies
The replacement of a Residential fixture or appliance that meets all three of the foilowing
requirements:
1) Does not require modification to electrical or gas service.
2) Has a total cost of$500.00 or less; excluding the cost of the fixture or appliance:
and
3) Is improved, installed or replaced by the homeowner or licensed contractor.
Skip next section; Cost of Permit � 15.00
State Surcharge $ .50
Mail-In Fee $ 1.50
If above does not apply, follow guidelines below:
1. Contract Price* is .0125% of job with a Minimum Fee of $35.00 _ ,
�1 ,-C _ t"i � ;�ce
X .oi2s �
(contract price) (minimum$35.00)
2. State Surchar�e. ** Add the State Building Code Division a Minimum Fee of($ .50)
:�'S��`% .000s � /� 9 �
(contract price) (minimuin$.50)
3. Posta�e and Handlin� (Only mail-in applicat�ons) � 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) � ��' -��
*CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work
including materials,labor,profit,and other fixed costs. It is the amount to be charged to the customer for the work
done. If any material,equipment,labor,or installation is furnished by the owner,tenant or any other party the
reasonable market value of such items must be added to the estimated cost or contract pnce for permit fee purposes. In
the event that there is a dispute on the amount of the job cost,thc City may request the submission of a signed copy of
the actual contract.
**Thc STATE SURCHARGE is.0005 of the contract pricc under$],000,000 or$.50-whichever is greater.For
valuations over$1,000,000 call the Department of]nspectional Services for the price.
The undersigned hereby applies to the Ciry for issuance of a Mechanical Permit,agrees to do all work in strict
accordance with the ordinances of the City and thc r� tio �qf the Minnesota State Building Code,a�d certifics that
all statements madc on this applicatio�omp e, nd c rrect.
�'�Z��._..--' � �
Applicant's Signature: � Date: � /.� �
Approved By: ' Date:
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