HomeMy WebLinkAbout2013-00201 - gas fireplace CITY OF ORONO *2 0 1 3 - 0 PJ 2 0 1 *
_ 2750 KELLEY PARKWAY DATE ISSUED: 03/26/2013
, ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1250 FRENCH CREEK DR
PIN : 10-117-23-32-0013
LEGAL DESC : FRENCH CREEK
: LOT 005 BLOCK 002
PERMIT TYPE : MECHANICAL(> $500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUAT[ON : $ 4,000.00
NOTG: HGAT N GLO ESCAPE I35
APPLICANT MECHAN[CAL 50.00
FIRESIDE HEARTH& HOME STATE SURCHARGE MECH (VALUATION) 2.00
2700 FAIRVIEW AVE
ROSEVILLE, MN 55113 MAIL-IN FEE 2.00
(651)633-2561 TOTAL 54.00
Minnesota State License#: 20512060
OWNER
DANIELSON, SCOTT& SHARI
1250 FRENCH CREEK DR
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 Y'or only the work described and does
not grant permission for additional or related work which requires separate
permi[s. All provisions of laws and ordinances governing this type of work
shall be compied with whe[her or not specified herein.This permit will
expire and become null and void if construction authorized is no[
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 aze
requested in conformance w�th the State Building Code.This permit may be
revoked at any time for due cause.
�� �� � � / /
Applicant Permitee Signature Date Issued B ignature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE.
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� FOR CITY USE ONLY
`�p�� City of Orono
�
%'-�� `r��, P.O_Box 66 Date Received: Permit#
' 2750 Kelley Parkway
�� r''°'� ,� I' Crystal Bay MN 55323 Approved By Amount$:
���:'� a E� Phone(952)249-4600 Fax(952)249-4616
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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 RECE[VE 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 perrr►it 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 fmal). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before f►nal.
TYPE OF PERMIT
Check All That A 1
�Q Residential ❑Commercial(Approval Required)
/�
�New ❑ Additional ❑ Repairs ❑Replace
Job Site/Owner Information:
Site Address: f � �b �f�n c(� c rcc k (,�'.
Owner: ,S �ti� � I.�c.n� e �so^ Mailing Address: /o'?SD �G.�cti L�y��` ��
��Ty: v�' �.-� Z��� m N Z�P: s-s3 y i
Home Phone: Alternate Phone: ���- 3 � d' �.3/��
Contractor Information:
HEARTH & HOME TECHNO�OGIES
Contractor: Contact Person: �a FIRESIDE HEARTH & HOME
Lic BC662656
Address: State Bond#: 2700 FAIRVIEW AVENUE N
113
City: Zip: Expiration Date: 651.633.2561
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: ��q�n �( O
Wood Burning Fireplace
❑ Wood Stove Model No.: F S 4�`(�e �3 5
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations ��
FUEL STORAG E (Must be approved by Fire Marshal!if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE O1VLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
A � ,+
PERMIT FEE CALCULATION(S)
BASED OFF -2002 STATE STATUE
❑ Yes,this section appiies
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 contractor.
Skip next section, if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-[n Fee(If Applicable) $ 2.00
Total Permit Fee $
PERMIT FEE CALCULATION S -JOBS OVER$500.00
If above does not apply;follow guidelines below:
l. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
y�1117�.�� x.0125 $ S�.�U
(contract price) (minimum$50.00)
2. STATE SURCHARGE
�G�• �� x.0005 $ Z. ��
(contract price)
3. POSTAGE& HANDL[NG(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ,�7 •��
■ * 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 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. ln 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: �..�� Date: .� �o /.�
-7
Reset Form
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W` AT TIME �
CITY OF ORONO CALLED IN - �
INSPECTION NOTICE SCHEDULED ' �
PERMIT NO.�d/3`Oa�D� COMPLETED
ADDRESS �°Z.SO �7��LQ�,r'�. Ci�-Q-�'�- ,�/'
OWNER TELEPHONE NO. ��Z -3�3 �7��
CONTRACTOR ���-¢--
>; DESCRIPTION �/ l`'�= � �� �'�`P ��r �57�
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ 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
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑WORK SATISFACTORY:PROCEED OJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContractor on site:
Inspector. �
White Copyllnspector's File Canary CopylSite Notice