HomeMy WebLinkAbout2009-00215 - wood burning fireplace ' � CITY OF ORONO PERMIT NO.: 2009-00215
2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE ISSUED: OS/1U2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 2640 FOX ST
PIN : 04-117-23-42-0008
LEGAL DESC : REG. LAND SURVEY NO. 1249
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : F[REPLACE-GAS
VALUATION : $ 7,400.00
NOTE:
(2)GAS FAC"1'ORY FIREPLACES AND(l)WOOD BURNING FIREPLACE
BRAND NAME: MA.IESTIC-MOD�L NO: ODSR42A,500DVMLNV
APPLICANT MECHANICAL 92.50
AUTOMAT[C GARAGE DOOR& FIREPLACE STATE SURCHARGE MECH (VALUATION) 3J0
8900-109TH AVE N-#1000
CHAMPLIN, MN 55316 TOTAL 96.20
(763)571-2525
Minnesota State License#: 1990
OWNER
WESTLING, TOM
2640 FOX ST
WAYZATA, MN 55391-
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 rclated 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
commcnced 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 for due cause.
�,��-�-- .:S^ i// ,�� i i
Applicant Pcrmitee Signature Date Issued By Signature Datc
SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
' '� F+OR C�USE ONLY
. � �,�p�� City of Orono � .� /
P.O.Dox 66 Datc Received:��� Q Permit# � d�" �
�:,, 2750 Kelley Parkway
��`>.�"ry
.� �r--_ �. Crystal Bay,MN 55323 Approved By: Amount$: U
�d�'�j���..�o` (952)249-4600
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CITY OF ORONO —MECHANICAL PERMIT
(All Commercial permits must be approved bp the Building Official or Inspector and/or Fire Marshall)
GENERAL INFORMATION
L 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 warking days.
2. PernZit cards will be sent by return mail after a i-eview is completed. PERMITS ARE NOT
VALID UNTIL YOti RECEIVE 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 idenrification 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 App1y)
�Residential ❑ Commercial(Approval Required)
�New ❑ Additional ❑ Repairs ❑Replace
Job Site/ Owner Information: �
Site Address: p� �a �� S'f"
Owner: (,()eS�'�i�tG� �S�.Pjkt�ti,,� 1 Mailing Address: ot��'o �q� S f
/
City: OreonJ� Zip: 5'.53�(0
Home Phone: �o?--�f�/—Q�o Alternate Phone: �Z`' �yq?- �G�'��e�
Contractor Information: � �
Contractor: �,y�,¢,'�G���y����Contact Person: �,"S
Address: g�eo jO Q`��t v��/p�State Bond#: � �Io�93(�aS��
City: / Zip��/G Expiration Date: �" o?a— O g
Phone: �63-5`�-/'�S�S Alternate Phone:
[� Insurance—Current: r
1 /� oG o �g�9�Yr
, . ,
� � . � �` �:�M���.�1'�CAL�YS`TE�I��:B�I1�C'r��T� ,�;LT:E�D�
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 �a
Wood Burning Fireplace� �
❑ Wood Stove
❑ Wood Stove With Flue
Brand Name: M�e,��C� Model No.: ��S/e(�o2�
VENTILATION
Soo1�vM�v
❑ 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)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
• • c
. • ,
PERMIT FEE CALCLTLATION(S)
BASED OF.F - 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; excludine the cost of the fixture or appliance: and
3. Is improved, installed or replaced by the homeowner or licensed conn-actor.
Skip next section, if this applies; Cost of Pennit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $
�` PERMIT FEE'CALCULATION(S)=JOBS OVER $500.00 -�
�
If above does not apply; follo���guidelines below:
1. CONTRACT PRICE *is 1.25%of contrac price with a(Minimum Fee of$35.00)
/ / �� x.0125
$
(contract price) (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Miuimum Fee of�.50)
x.0005 $
(contractprice) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Appiications) $ 1.50
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $
• * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
pernvtted 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 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 of the Building Department at(952)249-4600 for the price.
�� '� '�` " ' �� MECHATIICAL 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: �'l�� S
3
�� - J� c� TIME v
CIT OF ORONO CALLED IN �f � /
INSPECTION NOTICE SCHEDULED � /�-�-3v
PERMITNO.�OD�- dvai�S COMPLETED
ADDRESS O��7� �� ��%i�2-�f
OWNER CONTR. � "
TELEPHONE NO. \ — S — �- '
� DESCRIPTION � `�� �� " � lL
� ❑ FOOTING �E ANICAL RI ❑ EX AV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAtNT. ❑ COMPLAINT
Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL �,� ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:Y YES_NO
� COMMENTS:
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4�WORKSATISFACTORY:PROCEED f� PROJECTCOMPLETE
WO CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �, pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ 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