HomeMy WebLinkAbout2003-P07022 - gas fireplace fs �!
PERMIT
CIT� OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 Po�o22
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Pernuts
(952) 249-4600 Date Issued: iiii9i2oo3
SITE ADDRESS: 4125 Highwood Rd
Mound,MN 55364
PID: 07-117-23-44-0084
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Pemut Type: Mechanical Pernuts Permit Sub-type(s): Gas Fireplace
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 35.00 Valuation• $ 1,100.00
State Surcharge Fee: $ 0.55
TOTAL FEE: $ 35.55
APPLICANT: Allied Fireside OWNER: John&Roberta Henrich
DBA:Fireside Hearth&Home 4125 Highwood Rd
2700 Fairview Mound MN 55364
Roseville,MN 55113
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.
, � a �
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Covies: 1-File(SiQnitures Required), 1-Auulicant, 1-Monthlv Reuorts, 1-AssessinQ, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR MECHANICAL PERiv1IT
Box 66 (27�0 Ke11ey Parkway)
Crystal Bay, MN 55323
GENERAL NFORMATION
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 BEG1N UNTIL THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Mechanical Desi�- 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. Identification of and specifications for w�ater heating
equipment shall also be 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-hour notice required.
7. House Heating Test Record inust be submitted before final.
Instructions
Complete all items on this a��?ication. Compute the pennit fee. Sign and date the certification.
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call
(952) 249-4600.
Please check one: � New ❑ Addition ❑ Repair ❑ Replace � Residential ❑ Commercial
.iOB SITE: �S' (�j��� ��� ��p:
Owner's Name: /, v Plnone Number:
Mailing Address: Cit
Y� Zip:
AlVied Fireside
�ontractor's Name: �baFiresideHeeAhara�+e Phone Number:
Nfiailing Address: z�ooN.Fe�a�. City: ��
o P�
'��1/g33-256�
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SYSTEM DESCRIPTION -
HEATING SYSTEMS
Quantity:
Make:
Model:
FueL•
Flue Size:
Input BTUs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
�'IREPLACES GAS LI�,rE ONLY
�' Gas factory fireplace ❑ Installing a Gas Line Only
❑ Wood burning factory fireplace with flue
❑ Wood Stove
❑ Wood stove with ilue
Brand I`Tame �� � (ciCo Model No. ��,�,�J
VENTILATION
No. Kitchen Exhaust duct recalculating cfm
No. Bath Exhaust(must have duct outside) cfm
No. Other Fans: Locations cfm
FU�L STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
❑ Installation or ❑ Removal
❑ Ftlel oil: gallons ❑ underground ❑ inside ❑outside
❑ LP Gas: gallons
❑ Other Gas opening
2
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PEFtMIT FEE CALCULATION(S)
2002 State Statute ❑ 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; excludin�the cost of the fixture or appliance:
and
3) Is improved, installed or replaced by the homeo�vner or licensed contractor.
Skip next section; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee $ 1.50
If above does not apply, follow guidelines below:
1. eontract Price* is .012�% of job with a Minimum Fee of($35.00)
/��,',(_;,,��� x .0125 $ �'; ,. ��:
on[ract price) (minimum�,35.00)
2. State Surchar�e. ** Add the State Building Code Division a Minimum Fee of($ .50)
�lj�J"` �>,:� x .0005 $ ;'�-.
(contract price) (minimum� .50)
3. PostaQe and Handlin� (O�aly mail-iri applicatiorzs) $ ��
4. TOTAL PE1L'VIIT FEE (Add lines 1-3 above) � r��-�3�
*CONTRACT PRICE or JOB COST means the actuai 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 installation is furnished by the owner,tenant or any other party the reasonable market value of sucti 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
thejob cost,the City may request the submission of a siJned copy of the actual contract.
**The STATE SURCHARGE is.0005 of the contract price under$I,000,000 or$.50-whichever is greater. For valuations over
$1,000,000 call the Department of Inspectional Services for the price.
The undersigned hereby applies to the City for issuance of a Mechanical Pern�it,agrees to do all work in strict accordance with
the ordinances of the City and the regulations of the Minnesota State Building Code,and certifies that all statements made on this
application are complete,true and c�ect.
Applicant's Signature: �_ ���-�� �1� ��-�" Date: ��/J-o�
Approved By; Date:
� 3
1 �� V �. �
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� DATE TIME
CITY OF ORONO V cn��Eo iN
INSPECTION NOTICE ��SCHEDULED �Z�3 .�.'.3U
PERMIT N0. �1 L 1C COMPLETED
ADDRESS �I� � �� ��h �t�� �/'�✓
OWNER CONTR. �/�z /�/G. ��/C,�-S�
TELEPHONE NO. '��D� �" �"��' � ��� �
� DESCRIPTION / � C-� /`��
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
`� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUM8ING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-46��
OwnerlCon e:
Inspector. �
White Copy/lnspector's Fil Canary CopylSite Notice