HomeMy WebLinkAbout2008-00312 - gas fireplace CITY OF ORONO PERMIT NO.: 2oos-oo3�2
2750 KELLEY PARKWAY
r
'` ORONO, MN 55356- DATE ISSUED: 10/20/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 1030 LOMA LINDA AVE
PIN : 07-117-23-14-0056
LEGAL DESC : LJNPLATTED 07 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 2,690.00
NOTE:
31 HEAT N GLO GAS FACTORY FP
APPLICANT MECHANICAL 35.00
FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 135
2700 FAIRVIEW AVE
ROSEVILLE,MN 55113 MAIL-IN FEE 1.50
(651)633-2561 TOTAL 37.85
Minnesota State License#:20512060 PAID WITH CASH OA1
OWNER
WOLLNER,LORI HUINKER&GARY
1030 LOMA LINDA AVE
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 goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if wnstruction 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 aze
requested in conformance with the State Buiiding Code.This permit may be
revoked at any time for due cause.
`�t-a,�.2 !�. / / ioi �o � pg
Applicant Permitee Signature Date Issued Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESC ED ABOVE.
�
` i FOR CITY(:SE O�LY
'' ��`� City of Orono
� ��`r\ P.O. Box 60 ' Date R�ceived. Pz'T���� I
� 0;= �� 2i�0 Kelley Parkwa,
�
�}a%� r �.' Crvstal Bav.'�[V:�32� Approved By �moun�5
a �.;
`"< t\.ttEi4�G`:/ �.�i=)=�9'401�0
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CITY OF ORONO - �IECHaNICAL PERI�IIT
(ail Commercial permi[s mus[be approved by the Buildin;Official or[nspecror and;br rire�[arhaill
� GEtirERAL ItiFOR1VIATION
1. You ma; apply for mechanical permits by mail or in person at the City offices. .�pplications will
be reviewed and a pernvt will be issued within two working days.
?. Permit cards will be sent by retum mail after a review is completed. PEIL�[fTS .aRE NOT
V,�.LID UNT[L YOU RECEIVE A PER�tiIIT. W�ORK MUST NOT' BEGIY UNTIL THE
PER:�iIT C�RD [S POSTED ON THE JOB SIT'E.
;. Liechanical Desi�ns—Complete calculations, details and specifications arz required for each
heating, ventilation, humiditication-dehumiditication, and air conditionin; installation includin�
heat loss,heat gain calculation, desi�n temperatures, equipment ratings and identification as to
tvpe, manufacturer and model. Data shall be presented on torm provided.
�. W'hen anv new construction or remodeling is involvzd, a separate buildinJ permit must be
obtained.
�. :�11 work must be done in accordance with the UniTorm tiiechanical Code-�State Buildin�Code
requirements.
6. All work must be inspected(rough-in and final). Call (9�2)2�9-4600.
(2�-48 hour notice required)
'. House Heatin�Tzst Record must be submitted befor� final.
TYPE OF PER�ti1IT �
(Check All That Apply)
� R�sidentia( ❑ Commercial(:�pproval Required)
� �iew ❑ :�dditional ❑ Repairs �Replace
Job Site ;' Owner Information: �
_Z��� J __
Site Address: �G'�v l��'Yl(.,�.- � .��r'� C ��
Owner: �O ��1f1 SL���-- ���1 (��.Ql�(.Q��Tailing Address:
C ity: Z ip:
Home Phone: Alternate Phone: ��a , ��"��- �`�� �
Contractor Information:
Contractor: Meeuth d�Home Technologies,Inc. Contact Person:
a res e ome
License 20512080 p� 7 � 9 9�d
�ddress: 2�0o N. Fatrvtew Ave. State Bond#:
6511g33-2561 (0�30 �?
City: Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance - Current:
1
�
� �1ECHANICAL SYSTE:�'IS BEI��G I�ST,�LLED t
.
H�_ar�ti�c sY�sT��Ts
Quantiry
:�take:
1�Iodzl:
FuzL
Flue 5ize:
Input BTlis:
Output BTL''s:
CF�L
COOL[�G S��STE�(S
Quanti[y:
�fake:
�Iodzl:
Tons:
H. Power
F[REPL.aCES
� Gas Fac�ory Fireplace
❑ w"ood Burning Fireplace
❑ ��'ood Stove
❑ w'ood Stove W'ith F(ue
Brand Name: �Q�.� ti ��L tifodel No.: CQ.W✓
�'ENTIL.aT[O�
❑ �;o. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Exhaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FL��EL STORaGE (�IUST BE ,�PPROVED BY FIRE M:aRSH.aLL)
❑ [nstalla�ion ❑ Removaf
.��. ,s,o,s�
Fuel Oil: gallons ❑ Underground [],Inside �]Outside
LP Gas: � gallons -
Other:
G.aS L[NE O�LY
❑ Outdoor Grill ❑ Other! List�Vhat& `Vhere:
2
, •
�
� '� PEIZ�tIT' FEE CALCULAI'ION(S)
� B�SED OFF - 2002 STATE STATUE
❑ Yes, this section app(ies
The repiacement of a R�sidential fixturz or ap�iance that meets ail three of the following requirement;:
1. Does not require modification to electncal or gas service.
2. Has a total cost of��00.00 or(ess; excludinQ the cost of the fixture or appliance: and
3. [s improved, installed or repfaced by the homeowner or licensed contractor.
Skip next section, it'this app(ies; Cost of Permit $ 1�.00
State Surchar�e � .�0
i�tail-In Fee(If.applicable) � I.�O
Total Permit Fee �
PER.�IIT FEE C�LCULATION(S) -JOBS OVER ��00.00 ,
� If abo��e does ao�apply; follow�uidelines below:
l. CO�iTR.�C'T PRICE * is 1.2�4�0 0[contract pnce with a(�(inimum Fee of�3�.00)
p``,Q�� " x.O 1>j � � —
�co�ltract pnce) (minimum 33�00)
2. ST.aTE SLRCH.aRGE ** �dd the State Bld�Code Div. Surchar�e (�Iinimum Fee of�.�0)
��(r �� x .000� � • �
(con�ract pnce) �minimum� .�0)
3. POST'�GE & E-I:a�iDLItiG(Onl��on Ntail-[n _�pplications) � 1.�0
4. TOT.aL PER.�IIT EEE (.�dd Lines I-3 Above) $ �� ' �
• �` CONTRACT PE�ICE or JOB COST means the actuai or estimated do(lar amount char�ed for the
permitted work includin� matenals, labor, profit, and other fixed costs. It is the amount to be charged
to the customer for the work done. If any matzrial, equipment, labor or installations are furnished by
the owner, tenant or any other party, the reasonable markzt value of such items must be added to the
estimated cost or contract pnce for permit fee purposes. [n the zvznt that there is a dispute on the
amount of the job cost, the City may request the submission of a si;ned copy of the actual contract.
� **The ST.-�TE SURCH.aRGE i� .000� of the Building Department at(9�3)249-d600 for the pnce.
N�ECI�ANICAL PER�b1IT APPLICAT'IOIv` AGREEVIENT
-['he undersigned hereby applies to the City for issuance of a i�lechanical Permit, agrees to do all
work in strict accordance with the ordinances of the City and the re�ulations of the State of
�Iinnesota, and certifies that all statements made on this applica[ion are complete, true and
correct.
\ - I -0 �
.app(icant's Si�nature: Date: �
,
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