HomeMy WebLinkAbout2016-00218 - gas fireplace , �
CITY OF ORONO * 2 0 1 6 - PJ 0 2 1 S *
2750 KELLEY PARKWAY DATE ISSUED: 03/04/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2565 DUNWOODY AVE
pl� : 20-117-23-21-0031
LEGAL DESC : TOWNSITE OF LANGDON PARK
: LOT 000 BLOCK 008
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 3,500.00
NOTG: (2) PETERSON GAS LOG SETS
APPL[CANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.75
TWIN CITY FIREPLACE STONE CO INC MAIL-IN FEE 2.00
6521 CEC[L[A CIR
EDINA,MN 55439- TOTAL 53J5
(952)941-2685 Payment(s)
Minnesota State License#:mech-MB682977 CREDIT CARD 0657 53.75
OWNER
RUCINSKO, MICHAEL&MARY
2565 DUNWOODY AVE
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 goveming this type of work
shall be compied with whether or not specitied herein.This permit will
expire and become null and void if construction authorized is not
commenced within I80 days of the date of issuance,or if consuuction 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.
( f o �c �v � , ;��
Applicant Permitee Signature Date Issued By 'gnature Date
Mar 03 16 02:22p Twin City Fireplace 9529422093 p.1
�CI USE On'LY
! /��A TO City of Orono /�}/1 � /�
. ,
/ �y P.O.[3ox66 Date R eir Permit?� �/Uv-
/ � 2;SOKeIIeyParkway
Crystflf Bay,MN 55323 Approved By: Amount$'
Phone{952)249-A660 FaY(952)249-4616
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`�kESH���G CITY OF ORONO—MECHANICAL PERM�T
(All Commercial perrni�s must be approved by the BuildingOffic�al orInspectorandlor F�re Marshall}
GENERAL INFORMATION
l. You may apply for mechanicaf permits by mail or in person at the Ciry offices. Apptications will
be reviewed and a permit will be issued within trvo working days.
2. Permit cards will be sent by return mail after a revie�v is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN LTITIL 7'NE
PERMIT CARD TS POSTED ON THE JOB SIT�.
3. Mechanical Desi�ns—Complete calculations,details and specifications are required for each
beatinp,ventilation.humidification-dehumidification,and air conditioning installation inc]uding
heat loss�heat oain calculation design temperatures,equipment ratings and identification as to
rype,mattufacturer and model, Data shall be presented on form provided.
4. When any new construc[i�n or remodeling is involved,a separate building permit must be
obtained.
�. All work must be done in accordance with the�Iniform Mechanical CodeiState Building Code
requ irements.
6. All work inust be inspected (rough-in and final). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be sabmitted before final_
TYPE OP PERMIT
{Check All That A 1
Residential ❑Commercial(Approval Required)
G New ❑.4dditional ❑Repairs ❑Replace
Job Site/ �wner Informat�on:
Site Address: 2�I.0� �� l� ���l 11� ��
Ownzr: �1�� � �l � Mailing Address: �jC��1/I/��.
Ciry: �� _, Zip:
L - 1 V�
Home h n : -- � - ��7�Alternate Phone:
Contractor Information:
Contractor: �1/1��{ U��'ontact Person: ��� I �(/���`T��✓
Address: ��Z� l�-�/� E� � State Bond#: N I I� {..(� 0 Z � ��
City: ���1GL— Zip:��xpiration Date: � � �
Phone: ��2'���� ���� Alternate Phone:
�lnsurance—Current: ��
1
Mar 04,16 12:04p Twin City Fireplace 9529422093 p.2
��'��' �1 �1'�'�'l�'�1,vi� t,';_1L'i V` � �'i✓ .
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�^l-_-v �CHANICAL SYSTEMS BEIh�G TNSTALLED
Vote: AlI Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes []No
n � '
HEAT'ING SYSTEMS �-�✓;���
Quan6ty: ! .'I 1�I �
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;�' ��!G-F�! �� � !�;'=� '�^, ,-
Make: �',. � �✓�iv`�� i�r�� �, �-,v„'-'����
Model: `�=;`-��1'�� ;^L-I,� ' ��
Fuel: �J� ;;�ui�� �j. �✓�
� (_,I
Flue Size_
� �y�^
Tnput BTI Is: '���! '��+%'� �7� �a�i;1 i i„ �
Output BTUs'
CFM:
COO�ING SYSTEMS
Quantiry: _
Make:
Model:
Tons:
H.Power
FIREPLACES
� � � �
Gas Factory�ireplace Brand Name:
1;; ��.�,/�,/,✓�,/;
❑ Wood Burnin�Fireplace � � \
❑ Wood Stove ModeE No.: ':���:%� �v�✓��; �
❑ �Vood Stove with F1ue/Nlasonry �
VENTILATION
[� No. Kitchen Exhaust duct recirculating ti-fm
❑ No. Bath Exhaust(must have ducL o¢tside) c�
❑ No_ Ocher Fans: Locarions J ��
FUEL STORA,GE (Must be qpproved by Fire 1Vlarshall if proposing ta abaRdon tank iR place.)
. ❑ Tnstallation ❑ Removal
Fuel Qii: gallons ❑ Underground ❑Inside ❑ Outside
LP Gas: gallons
Other:
GAS LiNE QNLY
❑ Outdaor Gritt ❑ Other f List What&Where:
2
Mar.O.'�, 16 02:22p Twin City Fireplace 9529422093 p.2
PERMITFEE CALCULATiONS - -���-�---�
1. CONTRACT PRICE * is 1.2�%of contract price with a(ltilinimum Fee of�50.OU)
x.0125$ �� � �
(contraat price (mioimum$50.00)
2. STATE S�TRCI3ARGE (�
- "__.x.0405 $����..�
(contraci p�ice}
3. POSTAGE&HANDLING(Only on Mail-In Appiications) $ 2.40
4. TOTAI.PERMIT FEE(Add Lines 1-3 Above) $ '�J ��`
■ * CONTRACT PRICE or JOB C�ST means the acttial or estimated dollar amount charged for the
pecmitte�work including materials,labor,profit,and other fixcd costs. It is the amount to be charged
' to the customer for the work dune. If any material,equipment,labor or installations are fumished by the
owner, tenant or any otE�er party, the reasonable market value of such items mus2 he added to the
esrimated cost or contract price for permit fee purposes_ ln the event t6at there is a dispute on the amount
of the job cost, the Ciry may request the submission of a siD ed copy of the actival contract.
MECHANICAL PERMIT APPLICATION AGREEMENT
The uudersigned hereby applies to the City for issuance of a Mechanical Permit, agrees ta do all
work in strict aeeordance with the ardinances of the City and the regula�ions of the State of
Minnesota.,and certifies that ail statements made on this application are complete,trete and correct.
Appiicant's 5ignature: \ �/ Date: � �
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DA �/� TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED , 3-a!-/.(� �(Z
PERMIT NO. ��� -�2� �conn ErEo
ADDRESS � S ��C�G(JD
OWNER �_ - EPHONE NO. �-7�7��� )
CONTRACTOR� /
� DESCRIPTION � �� �
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
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
Z
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑ RRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-46��
OwnerlContra n site:
t
Inspector.
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ite Copyllnspector's File Canary CopylSite Notice
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C �
D E TIME
CITY OF ORONO CALLED IN ��y 1 �
INSPECTION TICE_�u p SCHEDULED �
PERMIT NO 0 COMPLETED
ADDRESS S �
OWNER - LEP NE O. � � `a �-3
CONTRACTOR � 1 � �
� DESCRIPTION � ��� " �
lL ❑ FOOTING ❑ DEM -FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLIN
O ❑ 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
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEEi YOU:_YES_NO
��., COMMENTS:
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� � 94.5 �/�iCS 9� Qi�" ���5� 11�i Ri2�"�Ev
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2 �a�l �% �rtGLo/ - / �'16��c?iC� cL ?�'��c1�
� 3-�i-16 �
j �s'!�5� /r! 4L��//.,�- y�,,�r,v� "—
W �6RICSATISFACTORY:PROCEED O�Cb��~ O�ROJECT COMPLEfE
��RRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTiON TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN
;TOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
'PECTION REQUIRED.CALL TO ARRANGE ACCESS.
^all forthe next inspection 24 hours in advance. (g52) 249-4600
�tractor on site:
�l- � �^' '7`� -
White Copyllnspector's File Canary CopylSite Notice