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Home My WebLink About2009-00887 - gas fireplace . CITY OF ORONO PERM[T NO.: 2009-00887 ' 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE [ssuEn: 12/10/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 1991 FAGERNESS POINT RD P[N : 18-117-23-41-0001 LEGAL DESC : FAGERNESS : LOT 000 BLOCK 000 PERMIT TYPE : MECHAN[CAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIREPLACE-GAS VALUATION : $ 1,700.00 NO"I'E: GAS LONG HEAT N GLO STF018 APPLICANT MECHAN[CAL 50.00 FIRES[DE HEARTH &HOME STATE SURCHARGE MECH (VALUATION) 0.85 2700 FA[RVIEW AVE ROSEVILLE, MN 55113 MISC FEE 0.00 (651)633-2561 MAIL-IN FEE 1.65 Minnesota State License#: 20512060 TOTAL 52.50 OWNER MILLIREN,GUY& SALLY 1991 FAGERNESS PT RD WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT The work for which this pennit is issucd shall be perfonncd according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work dcscribed and does not grant permission for additional or related work which requires separate permits. All provisions oY laws and ordinances governing this type of work shall be compied with whe[he�or not specitied herein.This permit will expire and become null and void if construction authorized is not commenced within l80 days of the date of issuance,or if construction is suspended for a period of 180 days at any time atter 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. ��'yc.Qt-�-Q (n-- / / �i�J�_, l l Applicant Permitee Signature Date Issued E3y S� ature atc SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . FOR CITY USE ONLY O¢��O City of Orono P.O.Box 66 Date Received: Permit# 2750 Kelley Parkway �� n"'Xr Crystal Bay,MN 55323 Approved By: Amount$: t��,�%��o�� (952)249-4600 ��:.,�ty'Dgpd��%: CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits must be approved by thc Building Ofticial or Inspector and/or Fire Marshall) GENERAL [NFORMATION 1. You may apply for mechanical permits by mail or in person at the City of�ices. Applications will be reviewed and a permit will be issued within two working days. 2. Permit cards wili be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNT[L YOU RECE[VE A PERMIT. WORK MUST NOT BEGIN UNT[L THE PERMIT CARD IS POSTED ON THE JOB S[TE. 3. Mechanical Desi�ns—Complete calculations,details and specifications are required for each heating,ventilation,humiditication-dehumidification,and air conditioning installation including heat loss/heat gain calculation,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 final). Call(952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before fina(. TYPE OF PERMIT (Check All That A 1 ) �Residential � Commercial(Approval Required) �New ❑Additional ❑Repairs ❑ Replace Job Site/Owner Information: Site Address: I �'T �/ � ��aP rn e s s P� R� Owner: ��y ►'n%�� tn Mailing Address: (�4/ �ac,sr�.asS �,eo,C City: ('rc��o Zip: SS 3�1 / Home Phone: �5�v?- �/7 � - 7y0 I Alternate Phone: Contractor Information: Contractor: Contact Person: , eart ome giea,Inc. dba Fireside Hearth 8 Home Address: State Bond#: ��cense 2os�2oso Poseville, 1AN 55113 City: Zip: Expiration Date: �51/sss-2sst Phone: Alternate Phone: ❑ [nsurance—Current: l 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;excludin�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 $ .50 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 1.25%of contract price with a(Minimum Fee of$50.00) ��v• �� x.0125$ ��. �� (contract price) (minimum$50.00) 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$SO) x.0005 $ � 5 U (contractprice) (minimum$ .50) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S Sa. �� ■ * 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. ■ **The STATE SURCHARGE is.0005 of the Building Department at(952)249-4600 for the price. 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:__j��_- Reset Form 3 MECHANICAL SYSTEMS BEING INSTALLED Note: All Geotherrnal 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 ��s /�.5. "'��p s J;�,� ❑ Gas Factory Fireplace Brand Name: ��A� n�( o ❑ Wood Burning Fireplace r � Wood Stove Model No.: .5 ��5 O/� ❑ Wood Stove With Flue VEIYTILATION ❑ Na Kitchen Exhaust duct recirculating cfin ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FU EL STORACE (Must be approved by Fire Marshal!if proposing to abandon tank in place.) ❑ Installation � Removal Fuel Oil: gallons ❑ Underground B Inside �Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill � Other/List What& Where: 2 �' " D E TIME � CITY OF ORONO CALIED IN � � INSPECTION tN��O�TtICE Q SCHEDULED l-7'll� � PERMIT NO. L�iJ� � ��O�� COMPLETED ADDRESS �'7� I �� OWNER CONTR.�'Lf"eSCC�_ TELEPHONE NO. _6 y2 �� DESCRIPTION �p ��Q'�- � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE Q ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP � SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP Q _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � � O a � O � W � Q � Z W � W � � •. d W ❑WORK SATISFACTORY:PROCEED ,i PROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED C UE CERTIFICATE OF OCCUPANCY W O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. � � Call for the next inspection 24 hours in advance. �952� 249-46QQ Owner/Contractor�On sit :f r Inspector. �/l v� White Copyllnspector's File Canary CopylSite Notice � DATE TIME � CITY OF ORONO CALLED IN `�'� _ INSPECTION N�IC _�� SCHEDULED � f�.� PERMIT NO. COMPLETED ADDRESS � OWNER CONTR. S! TELEPHONE NO.�� 3�3 �B 7'T' � DESCRIPTION � w/�-�- �r��f � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FIL�ING y ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS Q ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE 0 SEPTICMAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � w a o O �S-� �4 t �-4-e��— � / � - I `� - C> �( 0 � W � Q � Z W � W � � a � WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑ CORRECT WORK&PROCEED = ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. L, pHOTO TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�0 OwnerlContractor on site: � Inspector. � �r �� White Copyllnspector's File Canary Copy/Site Notice SEDGWICK HEATING & AIR CONDITIONING CO. HEATING ��BNQ �Z�� 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS,MN 55420 • (952)881-7739 TEST RECORD ADDRESS�� 1 1 �`-�'�"�� -'"" CITY r " � �" ' " " ' OCCUPANT OWNER �1 W� � _ �"-' SOLD BY ✓ INSTALLED BY MAKE LGI J��X,^ MODEL "� �� "`� � ��r/ M �� `-r SERIAL NO. �� ` INPUT �u �� ! THERMOSTAT Y�� VENT SIZE �.„-� � VALVE �ii {'�1� S�� TYPE OF LINER " 1�/� LIMIT LINER SIZE N� LIMIT SETTING FILTERS: SIZE v K NUMBER �f_ ` FAN SETTING WIRING � � �� PILOT TYPE •'� TEST TAG �`' IGNITION MODEL LIGHTING INST. � PILOT TIMING ` � �� S � t DATE TESTED I PRESSURE PERCENT CO2�� , ' l . � C) COMPANY TESTING �-��i INPUT CFH PERCENT 02 STACK TEMR 1 PERCENT CO C� NAME OF TESTER�y�� J`-'��v FORM 235(REV.6/08) FORM DISTRIBUTION: WHITE COPY-JOB FILE YELLOW COPY-CITY SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB NO.��J 8910 WENTWORTN AVENUE SOUTH • MINNEAPOLIS,MN 55420 • (952)881-7739 TEST RECORD ADDRESS � 1 � 1 ,� ' ' � CITY +�� OCCUPANT �� OWNER � ' SOLD BY INSTALLED BY �lf_fL'�j� � � ` G r�o�� v c�o c MAKE � � MODEL v� ` � , � SERIAL NO. �j/� �� INPUT �`'� THERMOSTAT V �~� VENT SIZE ✓ //✓ �� VALVE /'�/�1C�U"►'��[ TYPE OF LINER ��' LIMIT � LINER SIZE // �� f ss / { LIMIT SETTING / FILTERS: SIZE / C`��" `��NUMBER� ` � G � FAN SETTING �C �� WIRING ' �� `) � � PILOT TYPE TEST TAG l�C� / IGNITION MODEL ' UGHTING INST. ` � �G PIIOT TIMING ./C � ��'G / ! � S` � � DATE TESTED PRESSURE �`� PERCENT CO2 " /J �C // L� COMPANY TESTING �C ��L'�� G INPUT CFH ��`� PERCENT 02 �� _ � � U _��t�� STACK TEMP.�� PERCENT CO NAME OF TESTER FORM 235(REV.6/08) FORM DISTRIBUTION: WHITE COPY-JOB FILE YELLOW COPY-CITV