HomeMy WebLinkAbout2010-01114 - gas fireplace , CITY OF ORONO PERMIT NO.: 2010-01114
s 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 1 U15/2010
_ (952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1465 FOX ST
PIN : 02-117-23-33-0002
LEGAL DESC : UNPLATTED 02 1 17 23
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PRONERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 3,300.00
NO"Ck�: 1 1 II',A"1�N PLO GSDCAPE I30PB GAS FIREPLACF,
APPLICANT MECHANICAL 50.00
FIRESIDE HEARTH & HOME STATE SURCHARGE MECH (VALUATION) 5.00
2700 FAIRVIEW AVE
ROSEVILLE, MN 55113 MAIL-IN FEE 2.00
(651)633-2561 MISC FEE 0.00
Minnesota State License#: 20512060 TOTAL 57.00
OWNER PAID WITH CC# 2216
BALMFORTH, COLIN M& I
1465 FOX ST
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
I�he work for which this permil is issucd shall bc performed according to
the approved plans and specifcations,applicablc City approvals,and the
State E3uilding Code. This permit is for only the work describcd 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 specified herein.This 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 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 fo�duc c�Ause.
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Applicant Pennitee Signature Date Issued►3y gnature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO .
4
. •� FOR CITY USE ONLY
� O¢��O CityofOrono
P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
a r`�'• � Crystal Bay,MN 55323 Approved By: Amount S:
�i� '�'.'. .`o` Phone(952)249-4600 Fax(952)249-4616
t'�t�o$
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
PERMIT CARD IS POSTED OP1 THE JOB S[TE.
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 conshuction 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: _1�/ji� �ox S�•
Owner: C o�� � �c.,� r�-.-�'d r�l� Mailing Address: /�/!oS Fn� S f.
c��y: w h-rz�.�� zip: 5�39 �
Home Phone: Alternate Phone:
Contractor Information:
Contractor: Contact Person:
,.
Hearth 8 Home Technologies,Inc.
Address: State Bond#: dba Fireside Hearcn & Home
2700 N. Fairview Ave.
City: Zip: Expiration Date: Rosey��ie, MN 55113
s$iTsaa a�s�
Phone: Alternate Phone:
❑ Insurance—Current:
1
4
r 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
FI REPLACES
( Gas Factory Fireplace Brand Name: M�c.� ,., � �o
Wood Burning Fireplace
Wood Stove Model No.: E c�.p� Z 3 U �� _
Wood Stove With Flue
VENTILATION
No. Kitchen E�chaust duct recirculating cfm
No. Bath Exhaust(must have duct outside) cfm
No. Other Fans: Locations cfin
FUEL STORAGE (Must be npproved 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
�
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PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
� Yes,this section applies
The replacement of a Residential fixture or ap l�p �ance 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;excludinQ the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip ne�ct 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 1.25%of contract price with a(Minimum Fee of$50.00)
33��� X.oi2s$ �'o.vz�
(contract price) (minimum 550.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$5.00)
�3vU.vt� x.0005 $ /. Lo�
(contract price) (minimum S 5.00)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ,5,3•(�S
■ * 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 ar 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 times the Contract Price or a minimum of$5.00.
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: /� U
Reset Form 3
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CITY F ORONO ALLED IN ` ��
INSPECTION NOTICE CHEDULED � ��
PERMIT NO. �� COMP TED
ADDRESS �
OWNER TELEPHONE NO. / � /�'
CONTRACTOR
�: DESCRIPTION v�
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4i ❑ FOOTING ❑ P MBING FINAL ❑ EXCAV/GRAD�NG/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
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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
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
� ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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GW �iIORK SATISFACTORY:PROCEED C7 PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-Q6��
OwnerlContractor on site:
Inspector_
White Copyllnspector's File Canary CopylSite Notice
�_ ��TEn TIME ��
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CITY OF ORONO CALLED IN
INSPECTION N TI E SCHEDULED � ��
PERMIT NO. ��/ COMPLETED
ADDRESS �7lOS \,��S�
OWNER TELEP ONE NO.��Z 363 D�G�B
CONTRACTOR , � T7`�
>; DESCRIPTION ��'''"'—`�
�
lL ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
�
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-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
� ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
�STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
Owner/Contractor on site:
Inspector. �\
White Copyllnspector's File Canary CopylSite Notice