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Home My WebLink About2012-00143 - gas fireplace CITY OF ORONO * 2 0 1 z - 0 0 1 4 3 * 2750 KELLEY PARKWAY DATE ISSUED: 02/22/2012 „ ORONO, MN 55356- � (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 475 FERNDALE RD N PIN : 36-118-23-14-OO12 LEGAL DESC : HAUSER LAUER WCC ADDN : LOT 001 BLOCK 001 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIREPLACE-GAS VALUATION : $ 2,000.00 NOTt;: 1 HEA"I'N'GLO GAS PIREPLACE, MODEL NO.G024SP-NG APPLICANT MECHANICAL 50.00 FIRESIDE HEARTH & HOME STATE SURCHARGE MECH (VALUATION) 1.00 2700 FAIRVIEW AVE TOTAL 51.00 ROSEVILLE, MN 55113 (65l)633-2561 Minnesota State License#: 20512060 OWNER HOESLEY, JOE& SHELLY 475 FERNDALE RD N WAYZATA, MN 55391- ACREEMENT AND SWORN STATEMENT I'he work for which this permit is issued shall be performed according to the approved plans and specitications,applicable City approvals,and the State E3uilding Code. This permit is for only the work described and does not grant permission for additional or related work which requires separatc 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 niill and void if construction authorized is not commenced within I 80 days of the date of issuance,or if construction is suspended lor a period of 180 days at any time aRer work has conunenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may bc revokzd at any time 1or due cause. ,� �� '� �� ,�� ,/�. � L �_ (`��)�{�1(,f i i %l,l�.J � �.�%� -� _. �C Applicant Permitee Signature Date Issued E3y Signature Date SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED ABOVE. � . �a FOR CITY L'SE ONLY City of Orono 040�0 P.O.Box 66 Date Received: Permit# ��/ , y��ti t 2750 Kelley Parkway ,, � !� a �'�zr +� Crystal Bay,MN 55323 Approved By: Amount$: � ,� �n , � �d� ��``�4.�0'`� Phone(952)249-4600 Fax(952)249-4616 � L,�' ��Aa� CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) GENERAL INFORMATION L You may apply for mechanical pern�its by mail or in person at the City offices. Applications will be reviewed and a pernut 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 BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Designs—Complete calculations, details and specifications are required for each heating, ventilation,humidification-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 pemut 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 final. TYPE OF PERMIT (Check All That Apply) �Residential ❑ Commercial(Approval Required) ❑ New ❑ Additional ❑ Repairs ❑ Replace Job Site/ Owner Information: SiteAddress: y �� r�rnc��1�� Kc-� � Owner: ��,r%�/-a /-/oc�s(�� Mailing Address: ��S ��n c��, �� c.� City: �F c-n �% Zip: �5`�y 7 Home Phone: ��3 �`/S- ��-y�7 Alternate Phone: Contractor Information: HEARTH & HOME TECHN(��OGIES, INC. dba FIRESIDE HEARTH & HOME Lic. BC0512060 Contractor: Contact Person: �o�Enl��tEW AVENUE N ROSEVILLE, MN 55113 Address: State Bond#: 651.633.2561 City: Zip: Expiration Date: Phone: Alternate Phone: ❑ Insurance—Current: 1 ,� . ►, �" �� MECHANI�AL��Y�TE�IS B�I1�G�'�INSTALLE�I� � � � . �� { � 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 (/l U c��. � as Facto�Pireplace Brand Name: (�f�� (o ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: ��C� ,�� S�__�I�., ❑ Wood Stove with Flue/Masonry VENTILATION ❑ No. Kitchen Exhaust duct recirculating cfin ❑ No. Bath E�aust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (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 i �_ � � PERMIT FEE CALCULATI�JN(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 Pernut $ 15.00 State Surcharge $ 5.00 Mail-In Fee (If Applicable) $ 2.00 Total Permit Fee $ PERMIT FEE CALCULATION(S) -JOBS QVER$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) ��r2� .«Z� x.0125 $ (contract price) (minimum$50.00) 2. STATE SURCHARGE x.0005 � (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ■ * 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 pernut fee puiposes. 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'PERIUlIT APPT;ICATION AGREEMENT ,�.=:��E �, 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: T--�-=_��.� Date: � � �,� 3