HomeMy WebLinkAbout2010-00129 - fireplace gas ,� CITY OF ORONO PERMIT NO.: Zoiaooi29
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2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 03/08/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 4149 HIGHWOOD RD
PIN : 07-117-23-44-0018
LEGAL DESC : HIGHWOOD LAKE MTKA
: LOT 022 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 3,405.00
NOTE: HEAT N GLO 750 TRS-IPI
APPLICANT MECHANICAL 50.00
TWIN CITY FIREPLACE CO. STATE SURCHARGE MECH(VALUATION) 1.70
6916 WASHBURN AVE. S.
MINNEAPOLIS,MN 55423- MAIL-IN FEE 2.01
(612)282-2684 TOTAL 53.71
OWNER
KOCH,MARK&NANCY
4149 HIGHWOOD RD
MOUND,MN 55364
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 dces
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 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.
�y1�t,�.c-� fiw / / �__ / /
Applicant Permitee Signature Date Issued By ature ate
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV
�� FOR CITY USE ONLY
04��0 City of Orono
P.O.Box 66 Date Received: Permit#
2750 Kelleq Parkway
� '`� ► Crystal Bay,MN 55323 Approved By: Amount$:
' � �. u`� (952)249-4600
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CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permiu must be approved by the Building Ot�icial or[nspector and/or Fire Marsha►I)
GENERAL INFORMATION
L You may appiy 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 RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desiens—Complete calculations,details and specifications are required for each
heating,ventilation,humidiftcation-dehumidification,and air conditioning installation including
heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to
type,manufacturer and model. Data st►all 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.
T'YPE OF PERMIT
(Check All That A 1
Q Residential �Commercial(Approval Required)
❑New ❑Additional ❑Repairs ❑Replace
Job Site/Owner Information:
Site Address: 4149 Highwood Rd. Orono, MN
Mark Koch 4149 Highwood Rd.
Owner: Mailing Address:
Ci ; Orono Zi 55364
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Home Phone: Alternate Phone:
Contractor Information:
Contractor: Twin City Fireplace Ca Contact Person: Chris
Address: 6916 Washburn Ave. S. State Bond#: 93-GN-7023-3
Minneapolis 55423 01/16/11
City: Zip: Expiration Date:
Phone: (612)282-2684 Alternate Phone:
Q Insurance—Current:
1
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Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMALY ❑Yes Q No
AEATING SYSTEMS
Quantity:
Make:
Model:
FueL•
Flue Size:
Input BTUs:
Output BTi.Js:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
� Gas Factory Fireplace Brand Name: Heat 8�Glo
� Wood Burning Fireplace
Wood Stove ModelNo.: 750 TRS-IPI
❑ Wood Stove With Flue
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfin
❑ No. Bath Exhaust(must have duct outside) cfm
� No. Other Fans: Locations cfm
FUEL STORAGE (Must be app�oved by Fire Marshall ijproposdng to abandon tank in p[ace.)
0 Installation � Removal
Fuel Oil: gallons ❑ Underground �Inside �Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill D Other/List What&Where: For New Gas Fireplace
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❑ 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 co of$500.00 or less;excludine the cost of the fixtwe or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip ne�section,if this applies; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee S
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If above does not apply;follow guidelines below:
1. CONTRACT PRICE "is 1.25%of contract price with a(Minimum Fee of 550.00)
3,405.Q0 x.0125$ 50.00
(conuact price) (minimum 550.00)
2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Mioimum Fce ofS.50)
3,405.00 x.0005 $ 1.71
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 53.71
■ " CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials,labor,pmfit,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 aze furnished by
the ott�mer,tenant or any other party,the reasonabie market value of such 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 the job cost, the City may request the submission of a signed copy of the actual contract.
■ #'The STAT'E SURCHARGE is.0005 of the Building Department at(952)249-4600 for the price.
'$ �+..�-
T'he undersigned hereby applies to the City for issuance of a Mechanical Pernut,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 Signatur Date:—_i��0
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