HomeMy WebLinkAbout2014-00225 - gas fireplace , CITY OF ORONO * 2 0 1 4 - 0 0 2 2 5 *
2750 KELLEY PARKWAY DATE ISSUED: 03/20/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4055 ELM ST
P[N : 06-117-23-41-0106
LEGAL DESC : MINNETONKA SUMMIT PARK
: LOT 000 BLOCK 009
PERMIT TYPE : MECHANICAL(> $500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 3,000.00
NO"CI;: GAS FACTORY PIREPLACE- MODF.L SLR-C
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH (VALUATION) 1.50
FIRESIDE HEARTH & HOME
2700 FAIRVIEW AVE MAIL-IN FEE 2.00
ROSEVILLE, MN 551 13 TOTAL 53.50
(651)633-2561 Payment(s)
Minnesota State License#: mech-20512060 CHECK 2004010 53.50
OWNER
FRITZ, MATT
9125 LOUISIANA AVE N
BROOKLYN PARK, MN 55443-
AGREEMENT AND SWORN STATEMENT
The work for which d�is permit is issued shall bc performed according to
the approved plans and specitications,applicable City approvals,and the
State Building Code. 1'his permit is for only the work described and docs
not grant perniission 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 specitied herein.This permit will
expire and become null and void if construction auUiorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of I SO days at any time alter work has commenced.
The applicant is responsible for assuring all requircd inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
;;%i� G ___
3- � � --�y �- ,� �
Applicant Permitee Signature Date Issue y Signature Date
, F R CI' Y SE ONLY
� ¢��, City of Orono �^ �j� ' � C'�
P.O.Box 66 Date Receiv L`� Pennit ltG1/� ! /—7
�O O'•`; 2�50 Kelley Parkway C
� � R � Ctystal Bay,MN 55323 Approved By: Amount�: J�.�
°}r ��c�' Phone(952)249-4600 Fax(952)249-4616
>�t�o�,
CITY OF ORONO-MECHANICAL PERMIT
(All Comm�cial pami[s 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��ill be issued��ithin two working days.
2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECFIVP.A PERMIT. WORK MUST 1vOT BEGIN UNTIL THE
PERMTI'CARD IS POSTED ON THE JOB Sl'TE.
3. Mechanical Desians—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air condirioning instailation including
heat loss/heat gain calculation,design temperatures,equipment ratings and identif�ication as to
type,manufacturer and model. Data shall be presented on form provided.
4. When any new construction ar 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 wark must be inspected(rough-in and final). Call(952)249-4600.
(24-4i3 hour notice required)
7. House Heating Test Record must be submitted before fmal.
TYPE OF PERMIT
(Check All That A 1 )
Residential ❑Commercial(Approval Required)
❑ New ❑Additional ❑Repairs ❑Repiace
Job Site/Owner Informarion:
_ .� �
Site Address: ��S 5 �'-�m- ��
Owner: �'���i��' L����^-- Mailing Address: �Cl 2`1 G /L 7 � G�.s
City: /�����-�-�,y- �` Zip: �' �- 3G'"`�
Home Phone: �� 3 - 7 5`y- � y 3�j Alternate Phone:
Contractor Information:
HEARTH & HOM� TECHNOLOGIES Contact Person: "{
Contract�rba
- OME
�i�� �1�;�����
Address: 27G0 FkIR��r���,� ra�r;=n���� N State Bond#: Q U 3% ��
R05EVI�.t.F, M1�1 55113
City: CS1.633.�: Expiration Date: � � (' �`�
!`G i��Z -t�
Phone: Alternate Phone:
❑ Insurance-Current:
l
' MECHANiCAL SYSTEMS BEING INSTALLED
Note: All Geothermal Svstems will now rcquire a Site Plan& Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes [�d'o
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Pow�er
FIREPLACES
[� Gas Factory Fireplace Brand Name: ��N"��
❑ Wood Burning Fireplace
❑ Wood Stove Model No.: S L� —�
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen E�aust duct recirculating cfm
❑ No. Bath F,xhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Mast be approved by Fire MarskaU ijproposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
PERMIT FEE CALCULATION(S)
BASED OFF -2002 STATE STATUE
❑ Yes,lhis section applies
The replacement of a Residential fixture or apvliance that meets all three of the following requirements:
1. Does not require modification to electrical or gas service.
2. Has a total cost oY$500.00 or less;excludine the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Petmit $ 15.00
Staxe Surcharge $ 5.00
Mail-In Fee(If Applicable) $ _2.00
Total Permit Fee $
PERMTT FEE CALCULATION S —JOBS OVER$500.00
If above dces not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
3D��.. ��� X.oi2s$ 7�.�c
(contract price) (m io im u m$50.00)
2. STATE SURCHARGE
�_ �oC�� ��� X.000s $ i, ��
(contract price)
3. POS"I'AGE&F�ANDLING(Chily on Mail-In Applications) $ 2.00
4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) $ � 3 ��
■ * CONTRACT YRICE or JOB COST means the actual or estimated dollar amount charged for the
pennitted work including materials, labor,profit,and other fised costs. It is the amount to be charged
to the customer for the work done. If any material,equipment,labor or installations are fumished 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 far 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
conect.
Applicant's Signature: �G-""� ��� Date: �—2Q�— / l
Reset Form
3
ATE TIME ~
CITY OF ORONO CAL�ED IN �� '
INSPECTION NOTIC SCHEDULED�— — � = CrD
PERMIT NO�� --��5 COMPLETED
ADDRESS �D�SS �_-e� G1
OWNER TELEP NE NO.
CONTRACTOR
�: DESCRIPTION �
�
� ❑ FOOTING ❑ PLUMBI G FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE O SITE INSPECTION .
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN
0 STOPORDEH POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in a ance. (952) 24 - 0�
OwnerlConVactor on site:
Inspector.
White Copylinspector's File Canary CopylSite Notice