HomeMy WebLinkAbout2016-00078 - gas fireplace '� CITY OF ORONO * 2 0 1 6 - 0 0 0 7 8 *
� 2750 KELLEY PARKWAY DATE ISSUED: OU25/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3640 JACOBS MILL RD
PIN : 32-118-23-24-0010
LEGAL DESC : JACOBS MILL
: LOT 004 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 4,215.00
NOTE: NEW ADDITIONAL:GAS FIREPLACE(HHT)
APPLICANT MECHANICAL 52.69
STATE SURCHARGE MECH(VALUATION) 2.11
FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00
2700 FAIRVIEW AVE TOTAL 56.80
ROSEVILLE, MN 55113
(651)633-2561 Payment(s)
Minnesota State License#: mech-20512060 CREDIT CARD 4608 56.80
OWNER
HOFFMAN, KEITH&MARY
3640 JACOBS MILL RD
LONG LAKE, MN 55356-
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 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 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.
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Applicant Permitee Signature Date Issued By Signature Date
01-22-'16 13:03 FROM- T-594 P0001/0004 F-970
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Ci[y of Orono ,F _�` � � ,� ;--�b �
�O�/� P.O.T3ox bb Data Received: ��� `Pcrmif# , ' �, '
�./ 2750 Kelley Pxrkway r
Crystal Hay,MjJ 55323 'Appioved By: � M�) ArnOunt$;. ��l' `�
Phon�(952)249-4600 Fax(952)249-4616
y��qR ��.�'� CITY ON�OTtONO-MECIZr#NTCAL p�R1VTTT
�S H O (qIE Commarcial permits must be approved by�he 6uilding Oflicial orinspector and/or Fire Marshall)
GEIJ�EkA�;TN�'O�MATTON ,
1. You may apply for mechanical permits by mail or in person at[he Ciry offices. Applications will
be re�ierVed and a permit will be issucd within two working d�ys. �
2. Permit cards will be sent by return mail after a review is complcted, PERMITS ARE NOT �
VAC,717 CJ'NTI�,�YOCJ R�C�I'VE A pEILMIT. WORK MUST NOT�3�C�h"YJIVTII.,"A`H�, !
p�fiMTT CAT2ri IS�OST��ON T�T�.�0�SXTF.
3. Mechanioal Desi2ns—Complett ci�iculations,dctails and specifications are required for eaeh
heatin�,ventilation,humidifcation-dehumidification,and air conditroning installation includ'rng '
heat loss/heat gain calculat'ron,desi�n temperatures,equipment ratin�s and identification as to �
type,manuYacCurer and modal. D�Y�shsll be presented on form provitled. ;
�4. When any new construction or remodeling is involved,a sep2r&te building permit must be �
obtained, �
5. All work must lae done in accordance with the CJniform Mechanicel Code/State Buitding Code �
requirements. �
6. All work must be inspected(rough-in and final). Call(9S2)249-4G00. �
(24-48 hour nptice required)
7. 1-Iousc Hcating'T'cst�tecord must bc submitEcd bcforc final.
_ TY�E O�p�R1Vt�T _ ;
Check All That A l�y. �
�Residential ❑Commetcial(Apprv'val Required)'
New �Additional ❑Repairs ❑Replace '
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Job Sitc/Owner InYorxnation: �
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Site Adclress• �b �t� �����, �1�1 � � �
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Qwner: .���ailing Aiidress: �• �j � j
City: Zip: _
f-(ome phone: ` �� Alternate Phone:
Contractor Ynformation; �
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Contractor: FIR�SID� H�ARTH & HaME ContaCt Person: Leah �
Address: 2700 Fairview Ave N Statc Bond#:BC662656, MBG62572, PGG62571 �
Ci�,; Roseville, MN zr�.55113 �xpiration Date: (
phone: 651-B33-2561 Alternate�hone:�eah#651-638�3312
❑ Tnsurance^Current:
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01-22-'16 13:04 FRO�- T-594 P0002/0044 F-970
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Note:All Geothermai Systems will now require a i e Pt &Review by our Building Official. ;
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IS THIS GEOTHERMAL? ❑Yes ❑No �
�T�sATTNCr SYST�MS
�uantiry:
Make:
Model; �
r
Fuel:
Fluc Si2c:
Input BTUs:
Output BTUs:
CPM:
COOLING SYSTEMS i
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Qu�ntity: -
Make: �
Modcl; •
'fons:�
Fi.Power
�T�t��1;AC�S �
CrasPactory��ireplace �BrandNarrie: '�'�. . .
� Wood Burning•Firepiace �" .
❑ Wood Stove �Mpdal No.:: , G�l�'�GS�� :
❑ 'Wood Stove with.�iue/l�asanry
�r�r�rr�.arrorr �
[) No. Kitchen Exhaust duct recirculating �cfm �
[] No. �ath Lxhaust(must have duct outside) cfin
❑ No. Other Fans: Locations cfm i
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FUEL STORAGE (MY�sf be upp�'oved by 1"ire Mnrsl:nlC if propusing to nbR�edon tntrk!n place.) j
❑ Install&tion ❑ Removal j
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outs'rde �
�.n Cras: gallons
Othcr:
GAS LINE O1VLY
❑ Outdoor Grill ❑ Other/List'IYJhRt&Whcrc:
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01-22-'16 13:04 FROM- T-594 P0003/0004 F-970
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� Yes,this section applies
The replacement of a Residential fixture or appliance that meets afl three ofthe following requiremcnCs:
1, D,�g���ot require modification to eleotrical or gas service.
2. �Cas a toral of�500.00 or less;excludin�the cost of the fixture or appliance�and
3. fs improved,instAlled or repl�eed by thc homeowner or licenscd contrACtor.
Skip next section,if this applies; Cost of Permit � 15.00
State Surcharge $ 5.00
M�il-In Fee(ifApplicable) $ 2,00 c
Total Permit Fee �
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If above does not apply; follow guidelines below: �
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1. CONTRACT��tYC� * is L25%of contract price with a(Minimum Fee of$50.00) p
(,� � � �
1 � x.O 1'25$_��
(contracc price) (minimvm 530.00)
2. STATE SURCHARGE � ���
x.0005 �: ��
�( ontractprice) i�y, ,
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3. POSTAGE&HANDLING(Only on Mai1-In Applications) $ � i
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4. TOTAL PERMIT FEE(Add�,ines 1-3 Above) $�� i
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• * CONTTtACT P�tCGE or �OB COST means the actual or estimAted dollar a►nount charged for the �
permitted work including materisls,labor,profit,and other fixed costs. rt is the amount ta be charged ;
to thc custorner for the work done. [f any material,equipment, labor or installations are fiurnished by �
the owner, tenani or an�other party>the reasonable market value of such iYems must be added to the �
estimated cost or contract price for permit fce purposes. In the event that there is a dispute on the :
amaunt of the job cost, thc City may requcst the submissipn of a signed copy of the actual contcact. !
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The undersigned hcreb� applies to the City for issuance of a Mechanical Fermit, ag►�ecs to do a(1 i
work in stric# accordancc with the ordinances of the City and the regulations of the SCaCc of ,
Minnesota, and certifies that all statements made on this application are complete, true and
co�rect.
Applicant's Signature: �"'��!��U��� Date: ! ��_��
3
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DATE TIME v
CITY OF ORONO CALLEDIN �—aS/�6
INSPECTION NOTI�/� ��� EDULED a-as�-�b /o :3 c�
PERMIT NO. � PLETED _�
ADDRESS •3 �
OWNER � ELEPHONE NO.��Z"�����
CONTRACTOR
� DESCRIPTION
ty ❑ FOOTING ❑ DEMO-FI AL ❑ SEP C FI AL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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W RK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
� RRECT WORK 3 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 forthe next inspection 24 hours' vance. (95��;249-4600
OwnerlContractor on site:
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Inspector. '
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White Copyilnspector's Flle Cenary CopyfSite Notice