HomeMy WebLinkAbout2011-00772 - gas fireplace CITY OF ORONO PERM[T NO.: 2011-00772
2750 KELLEY PARKWAY
� � ORONO, MN 55356- DATE ISSUED: 08/02/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 2330 GLENDALE COVE LA
PIN : 34-118-23-33-0063
LEGAL DESC : GLENDALE COVE
: LOT 004 BLOCK 001
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 1,785.00
APPLICANT MECHANICAL 50.00
AUTOMATIC GARAGE DOOR& FIREPLACE STATE SURCHARGE MECH(VALUATION) 0.89
360 COON RAPIDS BLVD TOTAL 50.89
COON RAPIDS, MN 55433-
(763)576-7218
OWNER
RHOADS,N[CK&JENNY
140 CARLSON PKWY#308
MINNETONKA, MN 55345-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perforn�ed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This pemiit is for only the work described 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 Y'or 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 pemlit may bc
revoked at any time for due cause. �,��
C��-�-�-- 3'i z i�� ' ;� � �� C �`�'Y�C:r� i�i �� -� �
Applicant Permitee Signature Date Issued By Signatu e Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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FOR CITY USE ONLY —� �L'U7
" City of Orono �
�O� P.O.Box 66 Date Received: Permit#
+ � ��' � i 2750 Kelley Parkway
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�i,� �'��SR;r`: �* Crystal Bay,MN 55323 Approved By: Amount$:
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'�'¢,����$�o 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 pernuts by mail or in person at the City offices. Applications will
be reviewed and a permit will be issued within two warking 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 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 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 Apply)
r Residential ❑ Commercial(Approval Required)
r
❑ New ❑Additional ❑ Repairs ❑Replace
Job Site/ Owner Information:
� �
Site Address: `� ��C% �L�=i�%v.�L� �G'��=
Owner:l��/�� �t3 �d�JST Mailing Address: f�c� 1yZ�X -�0 lo
city: �1/�Le!'Lrt�oV zip: S53S j
Home Phone: Alternate Phone: (�/�' -��f'- 3 �-�'��
Contractar Information:
Contractor: ����r�T/G bcc� f i-��r�/k�ontact Person: ��F ft�.s�/tt��
Address: 3G�0 ��^'�'ot d���. State Bond#:
City: <c�o��'1✓ioS Zip:S��y33 Expiration Date:
Phone: ;'�3 S �� �,�/d' Alternate Phone:
❑ Insurance-Current:
1
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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: /h/�J�3'i7C
❑ Wood Buming Fireplace
❑ WoodStove ModelNo.: S-DO.j��i/.�/^%SC-
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ 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�f 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:
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� � PERMIT FEE�CALCliLATION(S) � � � �
i BASED OFF - 2402 STATE STATLTE
❑ Yes,this section applies
The replacement of a Residential fixture or ap�liance 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; excluding 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).,-=-JdBS,(OVER$SOO;UO
If above does not apply; follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
ff�7�5- �� x .0125 $
(contractprice) (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 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.
1VIECHANICAL PERIVIIT AP�LICATION AGREEMENT �
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
wark 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: ��� ��w�— ,.------ Date: �—Z ��
�--�,.
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