HomeMy WebLinkAbout2011-00312 - gas fireplace� _ CITY OF ORONO PERMIT NO.: 2011-00312
. 2750 KELLEY PARKWAY
` ORONO,MN 55356- DATE IssuEn: 05/09/20ll
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952 249-4600 FAX: 952 249-4616
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i •ADDRESS : 155 KINTYRE LA
� $IN : 32-118-23-43-0016
LEGAL DESC : KINTYRE TWO
�' : LOT 2 BLOCK 1
� PERMIT TYPE : MECHANICAL(>$500)
� PROPERTY TYPE : RESIDENTIAL
; CONSTRUCTION TYPE : FIREPLACE-GAS
` VALUATION : $ 4,250.00
NOTE: MARQUIS/MAJESTIC GAS FP'S
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APPLICANT MECHANICAL 53.13
AUTOMATIC GARAGE DOOR&FIREPLACE STATE SURCHARGE MECH(VALUATION) 2.13
; 8900 109TH AVE N
SUITE 1000 MAIL-IN FEE 2.00
; CHAMPLIN,MN 55316 MISC FEE 0.00
i (763)571-2525 TOTAL 57.26
OWNER
, ROLL&JACQUELINE WILLIAMS-ROLL,MICHAEL
' 75 FERNDALE RD N
WAYZATA,MN 55391-
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 sepazate
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
$uspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
':r ievoked at any time for due cause.
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„flpplicant Permitee Signature Date Issued By S' ture Date
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SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB
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,� � FOR•�ITY'USE ONLI'
, �,�0�� City of Orono � � �
P.O.Box 66 Date-�tece��ed. � Permit#;� �
2750 Kelley Parkway '
� ? ��, � Crystal Bay,MN 55323 Approve�By , Arr�ount$
' ' o Phone(952)249-4600 Fax(952)249-4616
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�gego$ .
CITY OF ORONO-MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL INFORMATI�N:
1. You may apply for mechanical 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. Pernut 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�—Complete calculations,details and specifications are required for each
heating,ventilarion,huxnidification-dehumidification,and air conditioning installarion including
heat loss/heat gain calcularion,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 perxnit 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`YFE O�'F:ERI�IIT
(Ch��k°A�Y'T�at�1 .pl j �� `
�
�Residenrial ❑Commercial(Approval Required)
�
�New ❑Additional ❑Repairs ❑Replace
7ob Site/Owner Information:
Site Address: /S�S- �'!.�'�/�✓�✓O�✓ ,aQ
Owner: /5'f/�T" �f-�/�s'T'N`�S MailingAddress: ���/ �%'��7�'�.�'�t-6�-r���•
City: �z�°/�9✓�'^� Zip: �S'3 9/
Home Phone: `�'/Se�- �171�- S'9'9 9 Alternate Phone:
Contractor Information:
Contractor: �.��11� ,�ioo�G d�/`���"�� Contact Person: 5�7=� �S�y�t�
Address: �W /49��h� State Bond#:
City: �i����'"'� Zip: ��� Expiration Date:
Phone: 7���-s 7����i8 Alternate Phone:
❑ Insurance-Current:
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Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑ Yes �No
HEATING SYSTEMS
Quanrity:
Make:
Model:
Fuel:
Flue Size:
Input BTiJs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
� Gas Factory Fireplace Brand Name: /��Q✓/S� r9�t�3TJC
Wood Burning Fireplace � ���/tN
❑ Wood Stove Model No.: !� S'�/.�(/�LNSC'7
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen Exhaust duct recirculating cfin
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfin
FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑ Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
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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 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.
Skip next section,if this applies; Cost of Pernut $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
If above does not apply; follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
�I'��� x;0125 $
(contract price) (minimum$50.00)
2. STATE SURCHARGE �
x.0005 $
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
■ * CONTR.ACT 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 installarions 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 undersigned hereby applies to the City for issuance of a Mechanical Permit, 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 Signature: � Date: �^/���
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