HomeMy WebLinkAbout2016-00858 - gas fireplace , CITY OF ORONO * Z 0 1 6 - 0 0 8 5 8 *
2750 KELLEY PARKWAY DATE ISSUED: 07/2U2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 763 BRIDGEWATER DR
PIN : 33-118-23-12-0091
LEGAL DESC : STONEBAY SEVENTH ADDITION
: LOT 4 BLOCK 1
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 2,336.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
(1) HHT GAS FIREPLACE
APPLICANT MECHANICAL 50.00
FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 1.17
2700 FAIRVIEW AVE MAIL-IN FEE 2.00
ROSEVILLE,MN 55113 TOTAL 53.17
(651)633-2561 Payment(s)
Minnesota State License#:mech-20512060 CREDIT CARD 4608 53.17
OWNER
Wooddale Builders
6117 BLLTE CIRCLE DRIVE
MINNETONKA, MN 55343-
AGREEMENT AND SWORN STATEMENT
The work for which this pertnit 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 S[ate Building Code.This permit may be
revoked at any time for due caus� �
� 1 `� / � / �
Applicant Permrtee Signature Date Issued B ignature Date
07-21-'16 12:36 FROM- F I RES I DE T-316 P0001/4044 F-845
�(� U(o�.5 %��70� (
$012 C Y US�ONtY Q�
� City of Orono �� / �/ �f U .
� � P.O.Box 66 Dbte �v ! Perm;t v�
Q 2750 Kclley POrkway
Crystal Bay,MN 55323 .,,pproy ay: Amount$r .
Phone(952)249-460o Aax(9$2)249•4616
y��"�xFSHo�-�'G� CITY Q�'QRQNO—MECHANICAL PERMIT
(All CommerCi01 permits musl be appt'oved by the Building OfliCiel or Cnspcctor nnd/or rirt Marshall)
GrENERAL 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'►ssued vvithin tw�working days.
2. Pcrmit cards will be sent 6y 7eturn msil after a rcviaw is completed. PERMITS ARE NOT I
'VALID UNTIL YOU P�EC�Y�A P��tMIT. WORK MUST NOT BEGIN UNT1�,'fH�
PERMIT CARD IS POST�p ON T�iC.�OB SITE. ±
3. Mechanieal besi�ns—Complete ca]culations,details and spccifications are required for each �
heating,ventilation,humidification-dehumidi�ica�ion,and air conditioning installation ineluding
heat loss(heat gain calculation,design ternper'atures,equipment ratings and identification as ko
type,manufacturtr and model. l�ata shall be presenCed on form provided.
4. 'When any now construction or rerr►odelrng is involved,a soparate building permit must be
obtained. '
5. All work must be done in accordance with tha Uniform Meehanical Code/State Building Code i
requirements.
6. All work must be inspected(rough-in and final). Calt(452)249-�600.
(24-48 hour not➢ce required) `
�
7. T�ouse�Teating Test Recard must he submitted before final. �
r�r��o�ra���T �
Check Al1 That A 1
Residential ❑Commerc'ral(Approval 1Zequired)
i
New ❑Additional []itepairs ❑Re�lace
Job Sit�/�w�er�nformation: '
SiteAddress: ��0 � ��'Id.c7�1.JGt,�.r' 4J'rti �� ;
,
�wner; �dOC?�.�,�� $v�.i ��-�'> M il'ng_ ddress lp ��-t� �l1�� ,� l��: ��Q :
...... ._.�- �---__.� _ l(� Q � ._ . �.�..
City: /�1 r v�v1���1 Zip: c��,3� �
C-1(ome phone: _�J 5Z-- 3�15—(�5y3 Aiternate Phone: i
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Contractor Tnformation: �
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Contractor: FIRESIDE HEARTH & HQME Contact T'erson; �A�I�-r� �
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Address: 2700 Fairview Ave N $tate Bond#:BC662656, MB662572, PC662571 I
Roseville, MN �55113 �
City: Zip. E�cpiration 17ate: ` / (�
Phon�: 651-633-2561 Alternate Phone:Leah#651-638-3�p(�
❑ Insurance—Curi�ent:
t
07-21—' 16 12:36 FROM— FIRESIQE T-316 POQ02/0044 F-845
����'�'��'�'V��'s�°'�z�...��� .�, ° , ,,,��,��*.�..;�--�-���'����, �,�,� .
NoEe: All Geothermal Systems will now requirc a Site plan&Review by our�uildin;Offcial.
IS THIS GEOTHERMAL? ❑�'"es ❑No '
HEATING SYSTEMS :
Quantity:
Make:
ModeL-
Fuel:
Flue Size:
Tnput$TUs:
Output BTUs: ,
CFM: '
i
{
COOLIIYG SYSTEMS '
�
Quantity: _ �
Make:
�
ModeL• '
Tons: �
T�.power �
FIREPLACES
� G�s Factory Fircplact Br�nd Name: �
[] Vlrood Burning�'ireplaae � _ ;
❑ Wood Sto�ve Model No.; ;
_ . _ .
_ _. _
_ Woo�-Sro�+e-w�it.h-�lue�/�Masonry.. ._. . ._.. ..._. — ._.—.—. _ ,
i
VENT[LATION ,
�
[� No. Kitchen�xhaust duct recirculating cfm ,
[] No. � �ath�xhaust(must have duct outside) cfm
❑ No. Other Fans: Locati�ns cfin
�'U�C,STOEtAGE (Must be approved by Fire Nlarsl�al!rfprvposing to abandon tank in plac�) i
I
❑ Installation ❑ Removal �
�'uel Oil: gallons ❑ Underground ❑Inside [�Outside �
LP Gas: gallons j
Other: �
GAS LI�VE ONLY �
I
❑ Outdoor Grill ❑ Other/List What&Whcrc: �
2
07-21-'16 12:36 FROM- F I RES I DE T-316 P0403/0404 F-845
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'����'� �y� ����" � � . < r F�Y�" ��'�U��+I�" ���y�i 7Y�y� z i
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❑ Yes,this scction applies
The rcplacomont of a Residential fixture or��pliance thst meets all three of the following requlCements: �
l. Does not require modification to electrical or gas serviee.
2. T-�as a total eost of$500.00 or lass;excludine the cost of the f xture or appliance:and
3. [s impro�vcd,installed or replaced by the homeowner oC licensed ContraCtor. e
t
5kip next section,if'this applios; Cost of perntit $ t5_00 �
St2te Surcharge $ 5.00 �
Mail-Ia�Fee(If Applicabla) $ 2.00 `
Total Permit�ee $ �
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Cfabove does nat apply;follow guidelines below: �
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
/ QP p0
�'���0, x.0125$ �Q.
contract price) (minimum 554.00)
?. S'X'A'C'�SC�RCHAR�E ���� o� It ' � e
, x.0005 $ � �
'�(conaact price) �
3. POSTAGE&HANDLING{dnl�on M&il-In Applications) $ � �
5�. � 7 �
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ i
I
� * CONTRACT FRICE or JOB COST means the 2ctual or estimated doll�r amount charged for the �
perm►tted work including materials,labor,profit,and other fixed costs. 1t is the annount to be charged i
Eo the customer for thc work d4ne. If any materiRl,ecjuipment, labor or installations are furnished by �
thc owner,tcnant or any other party,the reasonable market value of such itcros must be added to the �
-- esfimated-cost-orcontraot�pricc�for-permiY-fee-purpose3.--Cn•the event-that-there-is`a'dispute-�n�the
amount of the job cost,the City may requcst thc submission of a signed copy of the actual contract.
.,., .� - f� - �� y - � - i2 �-;�
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The undersigned hereb� applies to the City for issuance of a Mechanical Permit, agrees to do all
work in strict accordance w'rth the ordinances af the City and the regulations of the StaTe of
Mrnnesota, and certifies that all staternents made on this applieation are cornplete, true and
correct.
Applicant's Signature: � �i��`r Date: ����r��/
3
47-21-'16 12:37 FROM- FIRESIDE T-316 P4404/0044 F-845
VY VI IV 1�.�� � ��vi� � ��i�vivi . ...... � v..��� ����. " ___
Rieg�lman,Parker(NHT • �
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CAIL BACK FOR PAYM�NT ;
pARKER RIEGELMAN ?
fiS1-638r3306 !
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Purker Riegelman z
H�arth�xpert �
Morksit�g Cvordinaior ; �
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, Beat Sraqds,P�o(ets7onally Installed,Servfcc For Lif� � •
2700 N Fal�Vfew Av� I R4sevllie,MN 5511�3
W:651-538,3306 C:651-815-2422 �
Rie�eimanP(@hearthnhome.corn �www.fireside.com
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�'""�� DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE � SCHEDULED _,�,"
PERMIT NO. `' COMPLEfED
ADDRESS 'rT Cl,.�� /" 1�/ c�Ic� li 'r r`7`'�'1 ,��✓�
OWNER TELEPHONE NO. ��j�.��r��7c
CONTRACTOR ��/� �' ` �/�� f��`/�/
� DESCRIPTION �` � ��",/� �� CC: ���.�
ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPT�C 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
_
J ❑ DEMO-SITE ❑ SEPTIC I �TALL
2 OWNERICONTRACTOR TO MEET YiOU:_YES�NO
��., COMMENTS:
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W KSATISFACTORY:PROCEED O PROJECT COMPLETE
RECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑ RRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BE ORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in adv nce 2� 249-46�0
�
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopyfSfte Notice