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Home My WebLink About2012-01049 - gas fireplace - CITY OF ORONO ~ 2750 KELLEY PARKWAY * 2 0 1 2 - 0 1 0 4 9 * �� DATE ISSUED: 10/18/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 755 FERNDALE RD N PIN : 36-118-23-11-0028 LEGAL DESC : LYD[ARD HILLS : LOT 003 BLOCK 001 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIREPLACE-GAS VALUATION : $ 3,000.00 NOTE: I QUADRA FIRE COLUMBIA BAY INSERT APPLICANT MECHANICAL 50.00 FIRESIDE HEARTH& HOME STATE SURCHARGE MECH(VALUATION) 1.50 2700 FAIRVIEW AVE ROSEVILLE, MN 551 l3 MAIL-IN FEE 2.00 (651)633-2561 TOTAL 53.50 Minnesota State License#: 20512060 OWNER MITHUN,JEANNE 755 FERNDALE RD N WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMEIVT The work for which this permit 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 separatc permits. All provisions of laws and ordinances governing this type of work � shall be compied with whether or not specified herein.'I'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 l80 days at airy time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This pennit may be revoked at any time for d�e cause. �,�1�L.�iLC �/I�-= l l l l Applicant Permitee Signature Date Issued By S� ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRBED AB . c -� 53•� . �' FOR CITY USE ONLY �.;¢��\ City of Orono ,f� Q� P-O_Box 66 Date Received_ Parmit# 2750 Kelley Parkway �;,`� 1•,'"� �.�rl Crystal Bay,MN 55323 Approved By: Amount$: \ �� '' ' o'�i%� Phone(952)249-4600 Fa�c(952)249-4616 ��oe4// CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits 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 will be issued within two working days. 2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECENE A PERMIT. WORK MUST NOT BEGIN 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 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 final. TYPE OF PERMIT Check All That A 1 �Residential ❑Commercial(Approval Required) New ❑ Additional ❑ Repairs ❑ Replace Job Site/Owner Information: Site Address: ?SS F�t�1 D�w�e �� . Owner: �CAn n c i'V�;-��.�.r� Mailing Address: 75S F,��c �Q,d �/• Ciry: (�`-��yZ,c,.�� zip: SS�3`� l Home Phone: �' Alternate Phone: �/- �.35- $D7y Contractor Information: Contractor: Contact Person: H�RTH & NOME TECNNOLOGIES, INC. d & HOME Address: State Bond#: Lic. BC0512060 -,s�� „To��TG►n� nvFNUE N ROSEVILLE, MN 55113 City: Zip: Expiration Date: 651 53�_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: (�µ.r�o�t.+. t:�t Wood Buming Fireplace ❑ WoodStove ModelNo.: �o(r►M{��o- (3�-� �nsc/'�' ❑ 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 STORAGE (Must be approved by Fire Marshall ifp�oposing 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 fia�cture or appliance that meets all three of the following requirements: 1. Dces 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 Suroharge $ 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 1.25%of contract price with a(Minimum Fee of$50.00) .3��.C�0 x.0125$ SO.trv (contract price) (minimum$50.00) 2. STATE SURCHARGE 3�rr�'�•ur� x.000s $ /.Sa (contract price) 3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ,�,3. �'� ■ * 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 instailations 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: /rw�� ---� Date: /O /S/ /Z Reset Form 3 C � ��" ATE TIME ✓ CITY OF ORONO \�"� CALLED IN / INSPECTION NOTICE ,�/ SCHEDULED --� PERMITNO. ��/i/�' D��7y COMPLETED ADDRESS 7� j ��v!�t��--�- G�� N OWNER TELEPHONE NO.�� `3�3-��' CONTRACTOR �//�P,S%� � � � DESCRIPTION r � �L ��- ��5 � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING �� Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ 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-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPT�AL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU: ES_NO � COMMENTS: � W � � � O � � � �� o t�� W � Q � Z W � W � � GW �RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � O CORRECT WORK&PROCEED ' ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. rJ pHOTOTAKEN INSPECTOR WILL RETURN -� CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-460� OwnerlContractor on site: � Inspector. �o� � White Copyllnspector's File Canary CopylSite Notice