HomeMy WebLinkAbout2005-P08476 - gas fireplace PERMIT
(:;ITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 Poga�6
Crystal Bay, Minnesota 55323 Permit Type: Me�hani�al Pe�ts
(952) 249-4600 Date Issued: 2i2g�2oos
SITE ADDRESS: 3407 Eastlake St
Long Lake,MN 55356
PID: OS-117-23-13-0035
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Mechanical Permits Permit Sub-type(s): Gas Fireplace
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 2,500.00
State Surcharge Fee: $ 1.25
TOTAL FEE: $ 36.25
APPLICANT: Countryside Heating&Cooling OWNER: Rebecca Holzem
6511 Hwy 12 3407 Eastlake St
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.
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APPLICANT PERM[TEE SIGNATURE 1SSUED 13Y SIGNATURE
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 Ke11ey Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for mechanical permits by inail or in person at the City offlces. Applications
will be reviewed and a permit will be isstied 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 BEG1N UNTIL TH�
PERMIT CARD IS POSTED ON TNE JOB SITE.
3. Mechanical Desi�ns - Conlplete calculations, details and specifications are required for each
heating, ventilation,humidifiication-dehumidification, and air conditioning instalLation
incltiding heat loss/heat gain calculation, design temperatures, equipinent ratings and
identitication as to rype, inanufacturer and modeL Data shaLl be presented on form provided.
Identification of and specifications for water heating equipment sha1L also be provided.
4. When any new construction or remodeling is involved, a separate building permit must be
obtained.
5. A1L worlc must be done in accordance with the Uniforin Mechanical Code/State Building Code
requirements.
6. Alt work m�ist 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. Computc the permit fce. 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
„i Residential Commercial
JOB SITE: -�� C�l �.-'. C�`c�� S�. Zip: S-s3�"(
Owner's Name: �ed+fe�c�� F1o/ze��, Phone Nu►nber: ��2�- 3'"�%' �l"C�.>
Mailing Address: Se�•-.-c City: Zip:
Contractor's Name: �o,�frys,�f /-lt5 ,y�C/> Phone Number: 7�3�- `z'7 t- L� c.?C3
Mailing Address:���/ f��GV Y r Z CitV: �`'/�/� /'jc,�, Zip: �r3S``[
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SYSTEM DESCRIPTION
HEATING SYSTEI�IS
Quantity:
Make:
Model:
FucL
Flue Sizc:
Input BTUs:
Output BTUs:
CFM:
COOLIIVG SYSTEMS
Quantity:
Make:
Model:
Tons:
H. Power
r[REPLACES
�__ Gas factoty fireplace
Wood buining factory tireplace with flue
Wood Stove
Wood stove with flue
Brand Naine N�4�-N' G �o..✓ Model No. S L� � � �� � �`S �%�
VENTILATION
No. Kitchen Exhaust duct recalculating cfm
No. Bath Exhaust(must have duct outside) cfm
No. Other Fans Locations ctin
FUEL STORACE (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 ceplacement of a Residential tixture or appliance that meets a11 three of the following '
requirements:
1) Does not require inodification 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; Cost of Permit S I 5.00
State Surcharge S .50
Mail-In Fee � 1.�0
If above does not apply, follow giiidelines below:
1. Contract Price* is .0125% ofjob witl� a Minimum Fee of($35.00)
�.5 �'�-' x .012 5 S 3S.C%c>
(contract pricc) (minimtim�35.00)
2. State Surchar�e. ** Add the State Building Code Division a Minimum Fee of($ .50)
x .0005 S � ' z s
(contract pricc) (minimum$.50)
3. Posta�e and Handling (Only�nail-in applications) S 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) S ��•� �
*CONTRACT PRICL:or JO[3 COST means the actual or estimlted dollar amount charged for the permittcd work
including materials,I�bor,profit,and other fixed costs. It is the amount to be charge;d to the customer for the work
done. lf any material,equipment,labor,or installation is furnished by thc owner,tenant or any othcr party the
reasonablc 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 thc amolmt ofi the job cost,the City may request the submission of a signed copy ofi
the actual contract.
**The STATE SURCHARGE is.0005 of the contract price under$1,000,000 or$.50-whichever is greater.For
valuations over$1,000,000 call thc Department of Inspectional Services for the price.
The undersigned hereby aE�plies to the Ciry for issuance of a Mechanical Pcrmit,agrees to do all work in strict
accordance with the ordinances of the City and the rcgulations of the Minnesota State Building Code,and certifies that
all statements made on this application are complete,true and correct.
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Applicant's Signature: /��-z.l� yiL��� Date: Z�� ���'�
Approved By: Date:
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