HomeMy WebLinkAbout2011-00286 mechanical - gas fireplace F
� CITY OF ORONO PERMIT NO.: 20��-oo2s6
. 2750 KELLEY PARKWAY
, ORONO,MN 55356- DATE ISSUEn: 05/03/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 1190 LYMAN AVE
PIN : 35-118-23-43-0034
' LEGAL DESC : REG. LAND SURVEY NO. 1067
: LOT MB BLOCK MB
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 3,300.00
NOTE: 1 HEAT N GLO GAS FP
APPLICANT MECHANICAL 50.00
FIRESIDE HEARTH&HOME
' 2700 FAIRVIEW AVE STATE SURCHARGE MECH(VALUATION) 1.65
' ROSEVILLE,MN 55113 MAIL-IN FEE 2.00
(651)633-2561 MISC FEE 0.00
Minnesota State License#:20512060 TOTAL 53.65
OWNER
PALMER,BRIAN&JULIA
1190 LYMAN AVE
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
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 Building Code.This permit may be
revoked at any time for dye.cause.
+ (�r(� / / / /
Applicant Permitee Signature Date Issued ignature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
FOR CITY USE ONLY
,O,¢O�O City of Orono
P.O.Box 66 Date Received: Permit#
�. 2750 Kelley Parkway
� n`'*• R Crystal Bay,MN 55323 Approved By: Amount$:
e ''�`• '.:`c` Phone(952)249-4600 Faac(952)249-4616
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CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL INFORMATION
1. You may apply 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 RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desi�ns—Complete calculations,details and specifications are required for each
heating,ventilation,humidification-dehumidification,and air conditioning 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 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 6our notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
(Check All That A 1 )
�Residential ❑Commercial(Approval Required)
�New ❑ Additional ❑Repairs ❑ Replace
Job Site/Owner Information:
Site Address: lI 9(� �.�rv► c� ��i�'
Owner: � I'�µr+ Ma�M�� Mailing Address: �! q t� L y,,�u,� ���
c�ri: r,.�Ay�.��� Zip: 5539/
Home Phone: Alternate Phone: j,�/o?-,3�llo' 15�9�
Contractor Information:
,. ,
Hearth&Home Technologies,�nc,Contact Person:
COritTSCtOP: dba Firp�„�e �__,� _
License 20512060 ome
2700 N. Fairviaw qve,
Address: r7osE,v;�oe. nnN�:511� State Bond#:
���i633-2$61
City: Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance—Current:
1
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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.�or less;excludinQ 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 Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee S
' ���.����C�� .. '� -�-, -: a��''' ���� . *,. .;
If above dces not apply;follow guidelines below:
1. CONTRAGT PRICE *is 1.25%of contract price with a(Minimam Fee of 550.00)
33�-� X.oi2s$ .�'o.vz�
c��c�►ce) cmi�m�m sso.00>
2. STATE SURCAARGE
,3,3vr�. � X.000s $ /.Gs
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3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �3 •�o�
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollaz 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 doae. If any material, equipment, labor or 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 eve.nt diat 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.
�����:�,' ` � � �.
T'he undersigned hereby applies to the City for issuance of a Mechanical Pernut, agrees to do a11
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and cert�es that a11 statements made on this application are complete, taue and
correct.
Applicant's Signature: ,�...r---�._� Date: J�
��
3
�� C/ ' P E TIME V
`��CITY OF ORONO CALLED IN �` � (
INSPECTION NOTICE SCHEDULED S� 1�1 i�
PERMIT NO. � — �COMPLETED
ADDRESS � I q C� ��I/�l c�- � TT`''�-
OWNER TELEP ONE NO. �(a'• -'3�3���
CONTRACTOR l�cS1 cl�. ��I\��{�
� DESCRIPTION � �� S �i rP,��C��
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y � FRAMING ❑ MECHANICAL FINAL
O ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� � FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOILOW-UP
T ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ S IC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEEf YOU�YES_NO
c�., COMMENTS:
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��lORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W� ❑dORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTtON TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
�INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Cail for the next inspection 24 hours in advance. (g52) 249-4fi��
OwnerlContractor on site:
Inspector.
White Copylinspector's Rle Canary CopylSite Notice