HomeMy WebLinkAbout2015-01291 - gas fireplace CITY OF ORONO * Z 0 1 5 - 0 1 2 9 1 *
� 2750 KELLEY PARKWAY DATE ISSUED: 10/06/2015
� ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1340 FOX ST
P[N : 02-117-23-31-0056
LEGAL DESC : MINNETONKA BLUFES
: LOT MB BLOCK 14
PERM[T TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUAT[ON : $ 2,000.00
NOTE: 2 GAS FACTORY FIREPLACES(SUPERIOR)
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 1.00
HAGEN F[REPLACE SOLUTIONS
435 FAIRVIEW AVE N TOTAL 51.00
UNIT 2 Payment(s)
ST PAUL,MN 55104- CHECK 2357 51.00
(612)839-7595
Minnesota State License#: mech-MB680260
OWNER
Chamberlain Capital LLC
11578 CHAMBERLAIN COURT
EDEN PRAIRIE, MN 55344-
AGREEMENT AND SWORN STATEMENT
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 sepazate
permits. All provisions of laws and ordinances goveming 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 l80 days of the date of issuance,or if cons[ruction 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 State Building Code.This permit may be
revoked at any time for due cause. � / � J
1 (
�r��`5�.� ./`� �_ \
�p ,� ���,� ( � �_t�f �� r� I C� , ��, , 1 �
Applicant Permitee Signature ate [ssued By Signature Date
�
. _
� FOR CITY USE ONLY
City of Orono � ��� � �� ��i '�
' �O� P.O.Box 66 Date Received: 1C\�1 Permit# ��
� 2750 Kelley Parkway �,
Crystal Bay,MN 55323 Approved By: � Amount$: ti�I ��
Phone(952)249-4600 Fax(952)249�616
� �
� 1
�-�'�fSH���CG 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 return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERNIIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desiens—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)
QX New ❑Additional ❑Repairs ❑Replace
Job Site/Owner Information:
Site Address: 1 �� �`� � �� X ``-_�� �e -�' \
��1<;<,,M�'�C'_.d` � ��'R� �.�� ��`,.���o�'+1e S
Owner: ��1 *"Mai mg Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor; /`�'�e���n ���znl�z�z �7o1v�"eva �ontact Person: r)�.i tJ�
Address: �� �?�� ��-��v��w ���-� State Bond#: �n� j��`.Sr% :���%
City: ��, ���� Zip:��)�� Expiration Date: `�� >>,��� � -����ii
Phone: � 1�'�'1'7��,.% Alternate Phone:
❑ Insurance—Current:
1
' ` i
���� �r' °i��1VlECHAIVICA�SYSTENIS:BEING''INS'�A�I:I;ED . �
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
�.-�.,
a' Gas Factory Fireplace � Brand Name: ���?�? �;
❑ Wood Burning Fireplace �`
❑ Wood Stove Model No.: :� F1� �� l� � ��
❑ 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 Marshal!ifproposing 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:
�
R
` , t�
...a N � f tiw N*e�«,yr�. y, :; � . ., ■
,�:��u,.��,,,��;.,�„.;rt�.„; ..n,'PERMLT�MFEE"�CALCLTI;ATION(S) �h , M w '
""�'�� ' " �"�"� � "'.::'BASED OFF -2002 STATE STATUE �r� �=�i a�� .'� �'�..>r;; ";:
❑ 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 tota]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 $
,,;,'��.,�,;�"���P„ERIVIIT�'F,EE;�CALCi7I;ATION S �;-�JOBS`OVER�$5QO�Q0
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 125%of contract price with a(Minimum Fee of$50.00)
����C.�
x.0125$
(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 fumished 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.
i"�"�� `��;1ViECHAI�IICAL;';PERIVIIT'APPL`ICATION°�AGREEME,.� . '�
�� ��
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.
'�� r
Applicant's Signature: ����'�,�' `/ _JL L' �E Date: � U tQ � �
3
�� ���� DATE TIN1�
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED L'��" �� �
PERMiT NO.0�%l �S-�I z-�� � COMPLEfED
ADDRESS � �� C. �(,X �f
OWNER TELEPHONE NO. I��I Z "����S
CONTRACTOR �� ��-�
�; DESCRIPTION
� -�-- ��C
� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB Q MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC If�$TALL ❑ FOUNDATION/REMOVAL
� OWNERfCONTRACTOR TO MEET YOU:_YES_f�No
� COMMENTS: ��_I�l — I�;���� fE1'�� �
a l�, � . ' l/c.�,��.,ic - aK Cr� �ro��oc. vi1.�, . � ��
o � /e4,.a.�c� fi `�o s gl�a v g fo� b-� /=.P.
� �
� e� SC4r � �3�cS ��[G dG it v�''��a'�.�
O
�
Q � . L . F. • • V���.��s , �1�,�.�-� - o�'<
� � 5��1 �'/G coK`P�-r, 6 � /.-�� o�Ks�-..t�-;, -F
l2y �O d dCfisf�- �iG •ebc��
�
W / / � /� . �
� C�4 S �i�t G C!�r G �� /s /1 a`�i�s�
�
J �
GW�wORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
��CT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CWERING PERMANENT
❑CORRECTUNSAFECONOITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR Wlll REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on site:
Inspector. '"`�
White yllnspector's File Canary CopylSite Notice
��� =�- +- /i
DATE TIME��
CITY OF�ORONO CALLED IN
INSPECTION TICE � SCHEDULED I --�tc ' �
PERMIT NO. ��(F;-{,j ��{ � � �-
COMPLEfED
ADDRESS I ���-t C' �� �3� ��`
OWNER TELEPHONE NO.
CONTRACTOR ,a--``� � - � �4,�
�: DESCRIPTION
1� ��1 �) ����� "t
ll� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FIN�A���
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRA ING/FIL N
y ❑ 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
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ TIC INSTALL
2 OWNERfCONTRACTOR TO MEETaIOU: YES_NO
v�i COMMENTS:
a � �"- �'- - /��/ wo..�
oL�-�tr,p l��< � ap�r w,.�� ,<;.-c��'eD ^
�.
a
0
�
W
�
Q
�
2
W
�
W
�
J
W ❑WORKSATISFACTORY:PROCEED OJECT COMPLEfE
� ❑CORRECT WORK 8 PROCEED O ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CWERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContractor on site:
Inspector. / r`�' �
White Copyllnspector's Ffle Canary CopylSite Notice