HomeMy WebLinkAbout2013-00188 - gas fireplace CITY OF ORONO * 2 0 1 3 - PJ 0 1 8 8 *
2750 KELLEY PARKWAY DATE ISSUED: 03/2U2013
� ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 480 DEBORAH DR
PIN : 31-118-23-23-0007
LEGAL DESC : MCCULLEY FARM
: LOT 004 BLOCK 002
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 4,000.00
NOTE: EXTEND 4 CLASS A CHIMNEYS
EXTEND 2 CLASS B CHIMNEYS
APPL[CANT MECHANICAL 50.00
PRIORITY PLUMBING STATE SURCHARGE MECH(VALUATION) 2.00
17325 EUCLID AVE
FARMINGTON,MN 55024- TOTAL 52.00
(763)292-1615
OWNER
TRAPANESE,ALBERT&CHERYL
480 DEBORAH DR
MAPLE PLAIN, MN 55359
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specitications,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 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time afrer 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[ime for due cause.
/ / / /
Applicant Permitee Signature Date Issued By Si ture Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
r
FOR CITY USE ONLY
• City of Orono
�O�O P.O.Box 66 Date Received: Permit#
27�0 Kelley Parkway
. Crystal Bay,MN 55323 Approved By: Amount$:
Phone(952)249-4600 Fax(952)249-4616
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�qKEs H o���' CITY OF ORONO —MECHANICAL PERMIT
(All Commercial permits must be approved by the Building 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 RECENE A PERMIT. WORK MUST NOT BEGIN UNTTL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desiens—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
rype, 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 A ly)
���ential ❑ Commercial(Approval Required)
❑ New ❑ Additional ❑ Repairs ❑ Replace
Job Site / Owner Information:
Site Address: G%'?5 �, �-(`���
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
(�/, (r ��,/�
Contractor: �� arn� V L�Irv% Con"tact Person:
�
Address: /73�����% State Bond #:
� �r�
City: �Iy'6 v� Zip:� xpiration Date:
� C� ��,���� ��� �
Phone: � �0..2� .� Alternate Phone: �
❑ Insurance—Current:
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MECI-IANICAL SYSTEMS BEING 1NSTALLED
Note: All Geothermal Systems will now require a Site Plan & Review by our Building Official. ,
IS THIS GEOTHERMAL? ❑ Ye No
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H. Power
FIREPLACES ��� � C�S S �— � � ���r^,1c,r/1'f�
0 Gas Factory Fireplace Brand Name: "
❑ Wood Buming Fireplace
❑ Wood Stove Model No.:
❑ W d tove wi Flue/Masonry �
�°���' .� �-�.��� � ����-wry
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath E�ct�aust(must have duct outside) cfin
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by Fire Marshal/if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS L1NE ONLY
❑ Outdoor Grill ❑ Other/List What& Where:
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• PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
❑ Yes,tl�is 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 ar appliance: and
3. ls 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(lf Applicable) $ 2.00
Total Permit Fee $
PERMIT FEE CALCULATION(S)-JOBS OVER$500.00
If above does not apply; follow guidelines belo��:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
�—X.ot2s $ �.��1_ C�L'
(contract price) (minimum 550.00)
2. STATE SURCHARGE �` � �
x .0005 $ `�' �'� ���
(contract price)
3. POSTAGE& HANDLING (Only on Mail-In Applications) $ 2A0 �
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.
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 statements made on this application are complete, true and
correct. �
Applicant's Signature: Date: _ "",���/�
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