HomeMy WebLinkAbout2016-00651 - mechancial , CITY OF ORONO * z 0 1 6 - 0 0 6 5 1 *
2750 KELLEY PARKWAY DATE ISSUED: 06/06/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 787 BOULDER DR
PIN : 33-118-23-11-0132
LEGAL DESC : STONEBAY
: LOT 7&8 BLOCK 1
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 3,205.00
NOTE: (I)GAS FIREPLACE IN REC ROOM
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.60
FIRESIDE HEARTH& HOME MAIL-IN FEE 2.00
2700 FAIRVIEW AVE
ROSEVILLE, MN 55113 TOTAL 53.60
(651)633-2561 Payment(s)
Minnesota State License#: mech-20512060 CREDIT CARD 4608 53.60
OWNER
PIERCE FAM TRUST, MARY SUE
5491 ANDERSON ESTATES RD
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 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 180 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 all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Issued B ignature Date
06-06-' 16 11 :43 FROM- FIRESIDE T-083 P0041/0004 F-568
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FOC2 CCT UST ONI.Y "
�� Ci of Qrono �,��� J,,, (�
/'� P,O,Box 66 �R�te Recetv���;�;..�Parmit����� �
V 275�Kellcy Parkwny ' ,
Crystal Bay,MN 55323 Approvcd By: �_ Amount$
Phone(952)249-4600 Fax(9j2)�49-�616 <
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`�t,�k�,�o��,� CYT'SC O�'ORONO�MEC�IAN'YCAL PER.MIT
(All Commerctal permits must be approvcd by thc Building OtT'icial or Inspocmr bnd/or Fire Marshall} .
GENERAT�TN�0�2MATION. _ .
1. Yau may apply for mechanical permits by mail or in person at the Ciry offiees. Applications wi11
bc reviewed and a permit wiil be issued within two workin�days.
2. Permit cards will be scnt by return mail After a review is completed. T'�f2MITS ARE NOT
�IAC�II�UNTIL YOU REC�C V�A P��tMYT. WORK MUST NOT BEGIN U1VTT�.T�TE
1��,12MYT CARD IS PUS'1'�D ON TY��JOB SITE. �
3. Mech�nical besi_�—Complctt calculations,details and specifications are requircd for each
heating,ventilatian,humidi�ication-dehurnidification,and air condikioning installation including
heat loss/heat gain calculation,design temporatures,equipment ratings and identification as to
type,manu£f�Cttlrer atld model, Data shall be presented on form provided,
4. When any new constructian or remodeling is involved,a s�parate building permit must be �
obtained.
5. AI!work must be done in accordance with thc Uniform Macl�anical Code/State�uilding Code �
requiremcnts. �
6. All work must be inspected(rough-in and fnal). Call(952)249-a600.
(24-48 hour notiee required) ;
7, House Heatin�;Test Rccord must be submittcd before f'rnal. �
T�E o����vtrT �
Gheck P.lf`7'hat A 1
�tcsidential ❑Comriiercial(Approva(�equired)' �
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❑New Additioital ❑�epairs �Replace,
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rab Site/.Owner Trtformation: �
Site Address: _ ��� �J� � ��" �
"QVvn�r; _ � , ` ;
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�'�,r�i(i . Mailin�Address: '� �C/ ;
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City;. `ZiP� ,
Hom�'Phoi�e: ��P�/1 �` GI Z�-'.7.-�Q�-�`�Alternate Phone: ';
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Coittractor rnfprmatiari: ' '
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Contractor: FIR�SIDE MEARTH &HOME Contact Person; Leah ��
Address: 2700 Fairview Ave N State Bond#:�C662656, MBfi62572, PC662571
City: Rosevilte, MN Zin:55113 Expiratian 17ate:
phone: 651-633-2561 Alternate Phone:Leah#651-638-3312
Q lnsurance—Current: �
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06-06-'16 11 :43 FROM- FIRESIDE T-083 P0402/0404 F-568
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Notc:AU Geotherm�l Systems will now require a Site pian 8r Review by our Building Offci�l.
IS T�XS G�OTT�ERMAL? ❑Y'es ❑No
1•1�A,'�'TNG SYSTEMS
Quantiry: _ �
Make: __ —��
Mod�L•
Fuel:
Plue Si2e: _ _ �
Input�TUs; w -
Output BTUs: _—
CFM: _, r- ----
CUOT.yNG SYSTEMS
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Qusntity: ,
Make: �-,— !
Mode►: r
Tons: _�—
H.Po�ver �,
��7�iEp�LACES� �-�iGz �lf�)
� Gas fiactv�y Fireplace 'Btand Name: -_t"f �1�� ,.:_
❑ Wood Bumirig FiYepiacS � �qQ � ���/
❑ 'WoodSfd�ve, ModcSNo.: ��-t�l�w,�� /
[� Wood Stove With TV lue(Masonry
VF,hT1�,ATION
[] No. Kitchen�xhaust duct rccirculatin� cfm '
❑ No. Bath�xhaust(must hAve duct outside) cfrn !
❑ No. Othe�'Fans: I,ocations_� __ cfm
�YJ�r,STUXtA�� (Musl be ppproi�ed by�Yre Mnrsl:�tlC if proposing to ebandon tank J�t place.)
❑ Ynstallation ❑ Removal
Fuel Oil: galfans ❑ �nderground ❑Inside ❑Outside
L,P Gas: �gallons ,
Other: '�
CAS LINE ON�.y' i
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❑ Outdoor Grill ❑ Other/List What 8c.Where: ',
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06-06—' 16 11 :43 FROM— FIRESIDE T-083 P0003/4044 F-568
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❑ Yes,this section applies
The rcplacement of a Residen�ial fixturc or appliance that rneets all three ofthe followin�requircmenYs:
1. T7qes not require modsf►eation to electrical or gas servicc.
2. C�as a total cost of$SOO.UO or less;excludin the cost of the fixturc or appliance:and -
3. Is improved,install�d o,•rcplaoed by the homeowner or liccns�d eontractor_
Skip❑ext section,if this appNies; Cost of'Permit $ 15.00
St�te Surcharge � 5.00
M�il-Cn Fea(If Applicable) $ 2.00 -
Tptal permit Fee $
_�LrJ� .^t— �w . � /�1, a. /�, r. (y, (� (�"� � 7� '����„v.::.
� n �4 r �_.._ Y�� '!''M�. . \ 1°urs'� L.�f��i ' c��V.oaNHa zx�'��� . -.�$'��
tiSr+':rN,.'`_..-,�,y,x,}2� � __ ,
If'above docs not appiy;fo3low guidclines below:
1. COl�CTTtAC'T'PRICE *is 1.?S%of contract price with a(Minimum�ee of$50.00)
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� �7` x,0125$ _L�i� '
{contraGt p�icc}` {mfn3mum 550.00) l
. 2. STAT�S�IRCHARC� . �0��
x.0005 $
{Contract priCe)
3. POSTAGE&HAND�,1Nr(Oniy on Mail-Tn Applications) $._�'2.0 �
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4. TOTAL Y��iMIT FEE(Add Lines 1-3 Above) $
� "` CONTRACT PRiC� or 10B COST means the aotual or estimated doll amount charged for the
permittcd work including materials,labor,profit,and other fixcd costs. 7t is the amounC to be charged
to the customer far thc work done. If any material,equipment, labor or installations are furnishcd by
the owner,tenant or any other parry,the reasonablc market vatue af such items must be addcd ro the
estimated cost or eontract price for permit fec purposes. Tn the cvent that there is a dispute on the
amaunt of the job cast,thc Ciry may requtst the submission of a signed copy of the actual contract.
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The undarsigned hereby applies io the City for�ssuance of a Mechanieal Permit, agroes to do all
work in strict accordance with the �rdinances of the City and the regulations of the State of ;
Minnesota, and certifies that all statements made on this application arc complete, true and �
correct.
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Applicant's Signaturc: ' ^ bate: W /� ,
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� �� DATE
CITY OF ORONO CALLED IN
INSPECTION N TI �k. � SCHEDULED (� �C(�
PERMIT NO. � ��MPLETED
ADDRESS —7 C% -7 /�f��.t I��1'� ��-
..Sa-t o�,�h
OWNER TELEPHONE NO. ��� �a�� �-�c�Q
CONTRACTOR y`� �PS� �- �l��l�
� DESCRIPTION � � ����Q�� �-'� ���
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALIS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC N ALL
2 OWHERICONTRACTOR TO MEET YOU:_YES NO
v�i COMMENTS: ��5� L L'C-IL- �C�'X
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W ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
� RRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CdVERING PERMANENT
0 CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on site:
Inspector.n rr�-� '��
White Copyllnspector's File Canary CopyfSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI E SCHEDULED � �
PERMIT NO. ` co PLETED �
ADDRESS 7 C9u /G�
OWNER TELEPHONE NO.
CONTRACTOR
� DESCRIPTION
lN ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB �ECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ OOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL { ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTAIL
2 OYYNERICONTRACTOR TO MEET YOU:_YES_NO
c�., COMMENTS:
� JC�na /�� cu �� �.er'r��-� 1-.�lf,�
o mm �,q �,
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W� ❑WORKSATISFACTORY:PROCEED PROJECT COMPLEfE
W ❑CORRECT WORK&PROCEED ❑ I SUE CERTIFICATE OF OCCUPANCY
� ❑CARRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORHECT UNSAFE CONDITION WITHIN HOURS. ❑pHOTO TAKEN
INSPECTOR WILL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-460�
OwnerlCon r on site:
Inspecto.
ita Copyllnspector's File Canary CopylSite Notice