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Home My WebLink About2013-01104 - gas fireplace CITY OF ORONO * 2 0 1 3 - B 1 1 0 4 * 2750 KELLEY PARKWAY DATE ISSUED: 10/2U2013 ,' ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1937 FAGERNESS POINT RD PIN : 17-117-23-23-0012 LEGAL DESC : FAGERNESS : LOT 020 BLOCK 000 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIREPLACE- UAS VALUATION : $ 4,000.00 NOTE: 1 HEAT N GLO GAS 1=P G APPLICANT MECHANICAL 50.00 FIRESIDE HEARTH& HOME STATE SURCHARGE MECH(VALUATION) 2.00 2700 FAIRVIEW AVE ROSEVILLE, MN 55113 MAIL-IN FEE 2.00 (651)633-2561 TOTAL 54.00 Minnesota State License#: 20512060 OWNER BOLDENOW, ELLIE 1937 FAGERNESS PT RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT I�he�vork for which this permit is issucd 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 specitied herein."1'his 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 afrer work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the St�te Building Code.'I�his permit may be revoked at any time for due cause. `��1�C�.c-� �_ / / / / Applicant Permitee Signature llale Issued By � nature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER"THAN DESCRIBED A E. � - , ^ FOR CITY USE ONLY �O A' City of Orono •y P.O.Box 66 Date Received: Permit# � 2750 Kelley Parkway i Crystal Bay,MN 55323 Approved By: Amount$: � � Phone(952)249-4600 Fax(952)249-4616 �`��q ��.�� CITY OF ORONO—MECHANICAL PERMIT Kf S F�� (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL 1NFORMATION 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 issued within two working days. 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGW UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desi�ns—Complete calculations,details and specifications are required for each heating,ventilation,humidification-dehumidification,and air conditioning installation including heat loss/heat gain ca(culation,design temperatures,equipment ratings and identification as to type,manufacturer and model. Data shall be presented on form provided. 4. When any new construction or 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 work must be inspected(rough-in and finai). Call(952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before final. TYPE OF PERMIT Check All That A l �Residential ❑ Commercial(Approval Required) �New ❑ Additionai ❑Repairs ❑ Replace Job Site/Owner Information: Site Address: � l 3� �a��p (' /1 G SS Po%�� l�� Owner: F �I�C ►J o��G w Mailing Address: ��37 ��CSS r�• � c��y: wk-rz4�� z�p: ss3g 1 Home Phone: c1s�-,?S o ' 7�3`� Alternate Phone: Contractor Information: HEARTH & HOM� l'�CHNd�.(?(9IES Contractor: Contact Person: H & HOME Lic BC662656 Address: State Bond#: »nn FnrRvrF�n� evENUE N ROSEVILLE, MN 55113 City: Zip: Expiration Date: 651.633.2561 Phone: Alternate Phone: ❑ Insurance—Current: 1 - - � MECHANICAL SYSTEMS BEING INSTALLED Note: All Geothermal Systems will now require a Site Plan& Review by our Building Official. IS THIS GEOTHERMAL? ❑ Yes ❑No HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: Input BTUs: Output BTUs: CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: H. Power FIREPLACES ❑ Gas Factory Fireplace Brand Name: ��"� ��' 0 ❑ Wood Burning Fireplace �� G ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTILATION ❑ No. Kitchen Exhaust duct recirculating cfm ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfin FUEL STORAG E (Must be approved by Fire Marshall if proposing 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,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$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 Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ PERMIT FEE CALCULATION S —JOBS OVER$500.00 If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 125%of contract price with a(Minimum Fee of$50.00) y�v . � x A 125$ ��. � (contract price) (minimum$50.00) 2. STATE SURCHARGE �V�" �� x .0005 $ � �v� (contract price) 3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S S / `vU ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials, labor,profit, and other fixed costs. It is the amount to be charged to the customer for the work done. If any material, equipment, labor or installations are furnished 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 for 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 correct. Applicant's Signature: —�� Date: �� ,3 3 DATE TIME � CITY OF ORONO CALLED IN � iNSPECTION NOTICE SCHEDULED �� ` PERMIT NO.��.3—'��COMPLETED ADDRESS ��3� ��/�� OWNER TELEPHONE N0.3� 4�D�` CONTRACTOR �, �; DESCRIPTION /``` �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING y ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS Q O FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION � WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO- EPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PL BING RI ❑ SEP I F L ❑ FOUNbATION/fiEMOVAL 2 OWN ONTFiACTOR TO MEET YOU:�YES NO � COMMENTS: ' W O D�'LP a , � J 0 � � 0 � W � Q � 2 W � W � j d W� ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CEATIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on site: Inspector. White Copyll�spector's File Cenary CopyfSite Notice � � DATE TIME J CITY OF ORONO CALLED IN 1O-?�'i-l3 INSPECTION�,O ICE SCHEDULED /D 3D-/� /Gt•C1�7 PERMIT NO��J � COMPLETED ADDRESS OWNER TELEP ONE NO ` - .3 � CONTRACTOR � � � DESCRIPTION N � � ❑ FOOTING ❑ PL MBING FINAL ❑ EXCAV/GRADING/FILLING y ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORE/WETLANDS Q � FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREP�ACE ❑ SITE INSPECTION Q � RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP O COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INS LL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEP FIN p FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET _ _NO � COMMENTS: � W � � '�(� �7 � � S t i.�/'e 0 � � � 0 � W � Q � 2 W � W � j O � I�10lp@K SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WIIL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-460� OwnerlContractor on s' e: Inspector. . —�— White Copyllnspector's Ffle Canary CopylSfte Notice