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Home My WebLink About2009-00574 - wood fireplace � � � � CITY OF ORONO PERMIT NO.: 2009-00574 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE IssuEv: 09/10/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 2745 KELLY AVE PIN : 21-117-23-23-0028 LEGAL DESC : REG. LAND SURVEY NO. 0891 : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIREPLACE-WOOD VALUATION : $ 3,000.00 NOTE: 1 WOOD BURNING[NSERT QUADRA FIRE 2700I APPLICANT MECHANICAL 50.00 FIRESIDE HEARTH& HOME STATE SURCHARGE MECH(VALUATION) 1.50 2700 FAIRVIEW AVE ROSEVILLE, MN 55113 TOTAL 51.50 (651)633-2561 Minnesota State License#: 20512060 OW1vER WOOD,JAY&BARBARA 2745 KELLY AVE EXCELSIOR, MN 55331 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specitications,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. � — `�-� � l /U i G �j l l Applicant Pe itee Signature Date Issued By gnature ate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOu . � w L � FOR CITY�USE ONLY -� ,��, Cit}�of Orono � P.O.Box 66 Date Received: Permit# �� 1 2750 Kelley Parkway �.� �� r,`'. ti� Crystal Bay,MN 5532 Approved By: Amount$: �<+L�'�r�r;jL�,o�! (952)249-4600 \''/f&9H�� CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official or[nspector andior Firc Marshall) GENERAL INFORMATION 1. You may apply for mechanica]pernuts 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 Desi�ns—Complete calcularions; details and specificarions are required for each heating. ventilation, humidification-dehumidification, and air conditionin�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 wark 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 Heatin�Test Record must be submitted before final. TYPE OF PERMIT (Check All That Apply) ��Residential ❑ Commercial (Approval Required) �New ❑ Additional ❑ Repairs ❑ Replace / � Job Site/ Owner Information: SiteAddress: ,� 7��j ��/�y (q � Owner: �--��C`'{ lN c�c�� Mailing Address: � 7`/Sr �f'�//y /q�� c�ty: C��-�� Zip: 5�33 i Home Phone: �S o� � `/ 7 � ' y(�� Alternate Phone: Contractor Infornlation: Contractor: Contact Person: Hesrth d�Home Tachn�k�o, Licenss 205120li0 Address: 2700 N. FdrW�w Aw. State Bond #: Ro�.�j��, uN as», 851/d33-2Sa1 City: Zip: Expiration Date: � Phone: Alternate Phone: ❑ Insurance—Current: 1 1 1 � � 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: �� u��r�� F; r-c � Wood Burning Fireplace j �S�'�r T ❑ Wood Stove Model No.: � �G'9 L ❑ Wood Stove With Flue VENTILATION ❑ No. Kitchen Exhaust duct recirculating cfin � No. Bath E�aust(must have duct outside) cfm No. Other Fans: Locations cfm FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tahk in place.) .�rd.aorrip�c>1.:: _;.: ,; �a� g �;,,��r�, , Installation ❑ Removal t)80S f C4'.z � '��'� ` Fuel OiL Qallons Under�round Et t?P. NM._ o ❑ � ❑ Inside ❑ Outside f8'�-�:�,:�.P Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Gril1 ❑ Other/List What&Where: � � � • PERMIT FEE CALCULATION(S) BASED OFF - 20�2 STATE STATUE ❑ �'es,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; excludine the cost of the fixture or appliance: and 3. Is improved, installed or replaced by the homeowner or licensed contractor. Sldp next section, if this applies; Cost of Permit $ 15.00 State Surcharge $ .50 Mail-In Fee(If Applicable) $ 2.00 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$50.00) �� ' �� .0125 $ (contract pricej (minimum$50.00) 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of'�.50) x .0005 $ (contract price) (minimum 5 .50) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ■ * COI�TRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the perniitted 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 ar 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 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 STATE SURCHARGE is .0005 of the Building Department at(952)249-4600 for the price. MECHANICAL PERMIT APPLICATION 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: .�� Date: � 3 .�-�� ,/ �M �A TIME CITY OF ORONO CALLED IN � INSPECTION NOTICE HEDULED / � �pIL PERMIT N0.�1C�CJ-L�D57 OMPLETED ,_- • ADDRESS OWNER CONTR. �7L�l.Q/1.( � TELEPHONE NO. �-/�- O ' `�"'�l��4�� DESCRIPTION Q�[ � ❑ FOOTING ❑ MECHANICAL R ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FI L ❑ LAKESHORFJWETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPL4INT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J FINAL ❑ FOUNDATION/REMOVAL OWNER/C RACTOR TO MEET YOU:�YES_NO y COMMENTS: � W C � J O >. � O � W � Q � 2 W � W � � d � ❑WORKSATISFACTORY:PROCEED j�ROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITNIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cal1 for the next inspection 2a hours in advance. (g52) 249-4600 OwnedContractor on site: Inspector. ., White Copyllnspecto�'s File Canary Copy/Site Notice