HomeMy WebLinkAbout2005-P09250 - gas fireplace �
' PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P09250
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued:
9/30/2005
SITE ADDRESS: 80 Hackberry Hill Unit#
Long Lake,MN 55356
PID: 33-118-23-44-0022
DESCRIPTION:
Proposed Usc: Residential
Permit Class: General
Permit Type: Mechanical Permits Permit Sub-type(s): Gas Fireplace
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 valuation: $ 1,749.15
State Surcharge Fee: $ 0.87
TOTAL FEE: $ 35.87
APPLICANT: Owner/Self OWNER: 7ames Mock
1�1N 80 Hackberry Hill
Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APP ICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-Fil e(Signatures Reguired), l-Applicant, I-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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t� FOR CITY USE ONLY
� City of Orono %' ��/
40�� P.O.Box G6 Date Received: �1-�� ��Permit# � Q /��
�'� � 2750 Kelle Parkwa
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a �j��xr'" �* Crystal Bay,MN 55323 Approved By: Amount$:�
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CITY OF ORONO -MECHANICAL PERMIT
(All Conurercial permits must be approved Uy the[3uilding Ofticial or Inspecror and/or Fire Marshall)
GENER.AL INFORMATION
1. You may apply for mechanical pernuts by maii or in person at the City offices. Applications will
be reviewed and a pernut will be issued within two working days.
2. Peinut cards��ill be sent by retunl mail after a review is completed. PERMITS ARE NOT
VALID UIvTIL YOU RECEIVE A PERMIT. WORK Mt1ST NOT SEGIN Ul�'TIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechai7ical Desi�s—Complete calculations, details and specifications are required for each
heatiilg, ventilatioil, hunudification-dehunudification, and air conditioiling installation including
heat loss/heat gain calculation, desi�n temperatures, equipmeilt ratings and identification as to
type,manufacturer and model. Data shall be presented on form provided.
4. When auy new consri-uction or remodeling is involved, a separate building pernut must be
obtained.
5. All work niust be done in accordance with tl�e Uniform Mechanical Code/State Building Code
requirements.
6. All work must be inspected(rough-in aild final). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be subnutted before final.
TYPE OF PERMIT
� (Check All That A ply)
�Residential ❑ Conunercial(Approval Required)
�New ❑ Additional ❑ Repairs ❑ Replace
Job Site/ Owner Information:
Site Address: �� ���-k�� �s� I�} � l � Q �°���'
Owner: J ���u S �� �-�� Mailing Address: S n`^'` �
c�ty: � �� y1 �= z:�: �S 3 5 C;
Home Phone: q 5 � ' �� �' ``J `I � � Alternate Phone: (n 12-3 t� 3 -- � � 5 U
Contractor Inforn�ation:
Contractor: Contact Person:
Address: State Bond #:
City: Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance- Cunent:
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MECHANICAL SYSTEMS BEING INSTALLED "
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
❑ Wood Buining Fireplace
❑ Wood Stove
❑ Wood Stove With Flue
Brand Name: �u Z �- Q�t� Model No.: 5 P 3 �P
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FtiEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑ Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE O?!LY
❑ Outdoor Grill ❑ Other!List���hat&Where:
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PERMIT FEE CALCULATION(S)
BASED OFF - 2002 STATE STATUE
❑ Yes, this section applies
The replaceinent of a Residential fixture or appliance that meets all three of the following requirements:
1. Does not require modification to elech�ical or gas service.
2. Has a total cost of$�00.00 or less; e�cludin�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 Pernut $ 15.00
State Surcharge $ .50
Mail-Ii1 Fee(If Applicable) $ 1.50
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�35.00)
� 7`� `� � � � x.0125 $
(contract price) (minimum�35.00)
2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of�.50)
x .0005 $
(contract price) (minunwn S .50)
3. POSTAGE&HANDLING(Only on Mail-In Applicarions) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) �
a 'k 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 inarket value of such items must be added to the
estimated cost or conh-act price for permit fee puiposes. 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 conti-act.
m ** The STATE SURCHARGE is .0005 of the Building Departmei7t at(952)249-4600 for the price.
MECHAIVICAL PERMIT APPLICATION AGREEMENT
The Lindersigned hereby applies to the Ciry for issuance of a Mecllanical Permit, agrees to do all
���orl: in strict accardance 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
con-ect.
Applicant's Signature: a�z ����""�-- Date: �� " � �, � `� �
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