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Home My WebLink About2012-00040 - fireplace gas . CITY OF ORONO PERMIT NO.: 2012-00040 � 2750 KELLEY PARKWAY ORONO, MN 55356- DATE �ssuEu: OU17/2012 952 249-4600 FAX: 952 249-4616 ADDRESS : 1685 FOX ST PI IV : 03-117-23-44-0004 LEGAL DESC : HANSER ADDN : LOT 002 BLOCK 001 PERMIT TYPE : MECHAN[CAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIREPLACE-GAS VALUATION : $ 4,000.00 NOTE: I HEAT N GLO ESCAPE 36 GAS FP APPLICANT MECHANICAL 50.00 FIRESIDE HEARTH& HOME STATE SURCHARGE MECH (VALUATION) 2.00 2700 FAIRVIEW AVE ROSEVILLE, MN 551 13 MAIL-IN FEE 2.00 (651)633-2561 MISC FEE 0.00 Minnesota State License#: 20512060 TOTAL 54.00 OWNER HORNIG, STEVEN 1685 FOX ST WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT Thc��ork for��hich 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 separa[e permits. All provisions of laws and ordinances governing[his type of work shall be compied with��hether or no[specitied herein.This permit will expire and become null and void if construction authorized is not commenced within l80 days of the date o1�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 inspec[ions are requested in conformance wi[h the State Building Code.This permit may be revoked at any time fo`�e. �y`."� � � ��'l�'-ti- i i Applica�t Permitee Signature Date Issued By S nature te SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. � FOR CITY USE ONLY �,%'��j'��'�;;`,_ City of Orono ��¢ `�` �� P.O.Box 66 Date Received: Permit# �l�s. , �i`� 2750 Kelley Parkway �,�, n``?n �'�' Crystal Bay,MN 55323 Approved By: Amount$: '��' "�t��xi C,/� Phone(952)249-4600 Fax(952)249-4616 �tt�ss'i 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 RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desians—Complete calculations,details and specifications are required for each heating,ventilation,humidifieation-dehumidification,and air conditioning installation including heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to ty�e,manufacturer and rr�odel. Bata shaL'be pr:,sented on form Nrovid-ed. 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. Ali 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 esidential ❑ Commercial(Approval Required) ,�New ❑ Additional ❑ Repairs ❑ Replace Job Site/Owner Information: Site Address: r�� 'v�r �i`''(,.�j7'� Owner: Mailing Address: C:ty: Zip: Home Phone: Alternate Phone: Contractor Information: H�ARTH & HOME TECHNOLOGIES, I� Contractc�{�a FToccTn� ��,� � ��OME ntact Person: /�� Lic. BC0512060 Address: Z700 FAIRViFw nvF�� N State Bond#: ROSEVILLE, MN 55113 City: 651.633.256�ip: Expiration Date: Phone: G-/Z -�i 4� 3- Z / 7� 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: �74'J�f—�� ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: �� 3Lj ❑ Wood Stove with Flue/Masonry VENTILAT�ON ❑ No. Kitchen Exhaust duct recirculating cfm ❑ No. Bath Exhaust(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 � PERMIT FEE C,4LCULATI0�1(S)� �� BASED OFF - 2002 SrI'ATE STATUE ❑ Yes,this section applies The replacement of a Residential fixture or a�pliance 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 next 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$SOO.OQ If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) �dC9G� �L� x.0125$ � G�,G'�U (conhact price) (minimum$50.00) 2. STATE SURCHARGE /J /DC��'. ��G� x.0005 $ �Z:G>� (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ,�y�� ■ * CONTRACT PR10E or JOB COST means the actual ar 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. MECHANIGAL 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. / 7 Applicant's Signature: //C�� -y— Date: (�'�Z -�L Reset Form 3 � DAT TI M E `� CITY OF ORONO CALLED IN � �2 " INSPECTION AUQTICE SCHEDULED �� PERMIT NO. �lJ �Q�� MPLETED ADDRESS S� , OWNER , ELEPHONE NO. ��Z�3� ��Z CONTRACTOR �: DESCRIPTION � � '��'`� W ❑ FOOTING ❑ PLU ING FINAL EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI LAKESHORE/WETLANDS h ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W � � ��JNORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WlLL RETItRN �STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cali forthe next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice