HomeMy WebLinkAbout2015-00199 - gas fireplace CITY OF ORONO * Z 0 1 5 - 0 0 1 9 9 *
, 2750 KELLEY PARKWAY DATE ISSUED: 02/13/2015
� ORONO, MN 55356-
952) 249-4600 FAX: (952 249-4616
ADDRESS : 1555 MAPLE PL
PIN : 08-117-23-33-0030
LEGAL DESC : CRYSTAL BAY VIEW
: LOT 008 BLOCK 006
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 1,000.00
NOTE: GAS FACTORY FIREPLACE,LENNOX
APPLICANT MECHANICAL 52.50
STATE SURCHARGE MECH(VALUATION) 0.50
GLOWING HEARTH AND HOME MAIL-IN FEE 2.00
]00 ELDORADO DRIVE
TOTAL 55.00
JORDAN,MN 55352
(952)495-2927 Payment(s)
CHECK 20427 55.00
OWNER
Atlas Homes
14450 117TH AVE N
DAYTON, MN 55367-
AGREEMENT A1vD 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 a[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. /f%-�
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Applicant Permitee Signature Date Issued By Signature Date
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� GENERAL II�FOR_M;aTION __.. ----- -----
I. l��ni ma1� a����l� f��r i���•chanical ��crmits hy mail or in ���rs�m ;u thc Citt���11ir�,. ,1����licali�m����ill
hc rc��ic����d an�l a�crniit���ill hc i;�ucd u'i[hin t�t��i����n�kine�lav,.
' I'crmit car�i���ill h�,ent h��return mail a1l�r u rc•��ie��� i��umpl�icd. 1'L�_R��11�1�5 ,�RI� ��(�>T
V�:11 1[) l'?�Ti1 YOl' RL(�i�IVI: :� PI-R�11T. ���ORK �ICST 1'O"1� BE(:I� l�V"I�11.THF:
NH;12��IIT C:U2D IS POSTEU O1"THF:JOB SI"�E.
;. A�t��hanical I�c;i�i.5 (���mFil�tc calcttlution�.dettiil,an�l s��cciiicati��n,arc rc��uir�ci �or�aci�
h�atin��.�'�ntilation. httmiditication-dehumi�lilicaiiuo. :u��l air conditionin_ installatiun in�lu�iin�
he��t lo�s hc��t etiin ralcula[i�n.de,i;�n t�mperature�,cyui��m�nt ratin,_s��nd idrntiiic.�tirni a;;o
Iv�i�. manul.titur�r an�l mu�ici. i�ata ;';:il� b.'p����ni.<<a❑ ti��ii:�::;,����!�:i.
.}. A�'hcn anv nc���consu�urtion rn rcmodclin��i; im•ol�r�L a s�}�<ir,u�huilSin_permit must h�
ul�tain�cl
�. A�I ����rl: nnt�t b�d<�nc in accor�iance���ith thc Cnif��inn �1�ch�inical Ctidc�St,�tc Ruildin�_C't�dr
r���uircn�i�nt>.
6. 111��oi�k mu;t bc in;pect�d (rou�h-in and tinaU. Call (9�'_)��9--1h0O_
�2�3--1ti hour naticc reyuircd)
-. ilutuc I Ic,uin�_Tc:t R�ct�rd mu�t bc suhmittcd b�fore tinal.
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�Z�si�l�ntial ❑ ('umm�rcia;1.�\E���rc,�,al It�quirr�l)
� V'c��� ❑ :�ddition;il ❑ R���air: ❑ Ilc��lacc
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'� Job Sitc / Owner lnformation: �
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O���ner:���S �-�_ Mailint Acidress: ��� J� �� l ��-
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F�ior;l� Ph��ne��e3� �0��� �C��`� Alternate {'hon�: __ —
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C���ltractor Information: _�,
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C'ontractor: b\l� �ew ''���`�� C'ontact Pcr�on: —
�ddr�,s:�� � �� �Y' Stat� fiuncl �: m����
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t'it� ��C1. _��-- Zip:�w l�:xpirat�c�n [)at�:
i'honc: �S� ���-�}�-��D ,�ltcrnatc Phi�nc: ---- ---
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�; In;uranc�- Ctu-rcnt:
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MECHANICAL SYSTEMS BEING [NSTALLED _____�
'Votc: ��ll (icothcri���il S�'slcm;��ill now� requirc a Si[� Plun c� Rcvic��� hy our Eiuilclin�,Official.
IS "I�Ii1S GI�:OTHN:12�1.V.'' �� 1"�: ��'o
IIE::��l�l\G SI�STE�1S
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COOLi�G SI��STE:11S
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FIRF.i'L 1Ck�:S
Gas F,i�tot� I�ir�placr 13rnnd 1��:imc: ����__.
� \l���o�i F3urnin�� Fireplace ^� /�`� Uj'�
� ��uu�l Stu�� \1u�l�l \u.: _�.�,Jv___L_�_-.--`v
� \'����x1 St����c��ith Flttc M<u��nrv
� E\i li.;t"i�lO\
� �;�,,. - - — Kiinc�n 1=:xhaust_ duct ---r�cirrulatin�- _. _�fm
� 'Vu_ _ F3�ith Lxhuu,t(mu�t havc�uct out,i�lc) — _.cl��r1
� \�,. Uth�r Fans: Liic<ttiun: cfn�,
FI�F:I.S"I�ORAGf•: (.11r�st be apprnved hl' Fire.1'1��r�shtJl i/�prnpo.ci�eti to ubrn:dn�t tu�:k it�plac�.)
� In�talla�iun ❑ It�mu��al
Fu�l Oil: ��illon; ❑ l'ndcr�*round ❑ Inai�ic ❑ �)utsi�ic
l P Ga;: -_-- _ �all�,ns
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❑ Outd��rn�C�rill ❑ Otl�cr List �\hat�ti l'�'ncrc
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PERMIT FEE CALCULATION(S)
� � �BASED OFF - 2002 STATE STATUE �� �
❑ 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; excludin�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 $
� � PERMIT�;FEE�CALCULAT�OI�T S —JOBS��OVER$500.00 ��
If above does not apply; follow guidelines below:
I. CONTRACT PRICE * is I.25%of contract price wit,�a(Minimum Fee of$50.00)
�,v
"�1 i ' x .0125 $
(co�[ra� �pnce) (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) �
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
pern�itted 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, labar 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 contraet price for permit fee purposes. In the event that there is a disp�ite on the
amount of the job cost, the City may request the submission of a signed copy of the actual contract.
��� �MECI-�ANIC�AL PERMIT APPLICATION AGREEMCNT � ��
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 certif►es that all statements made on this application are complete, true and
correct.
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Applicant's Signature: � i ' Date: � ,� ���'��
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�i�.OVi�ING ��.ARZ`�f
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QME
Gas & Woodburning Fireplaces, Gas BBQ Grills,
Outdoor Patio Furniture& Home Products
February 19, 2015
City of Orono
Attn: Building Department
2750 Kelley Parkway
Orono, MN 55356
Building Department,
This is to inform you that the fireplace installed at 1555 Maple Place, permit number 2015-00199, for
Atlas Homes, Inc. was installed to all manufacturer specifications. The fireplace meets all necessary
clearances.
Sincerely,
�
Tim Shimek
President
Glowing Hearth & Home
100 Eldorado Drive
Jordan, MN 55352
Phone: (952)492-9276
Fax: (952)492-6006
www.g/owhearth.com
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'CAUTION; THIS fIREAlACE5 VENTlNG t5 COMPLETE: YES �RED CAUTION 7aG INSTALLED ON FIRHPLACE:
NO YES�— NO�� ^
{NSTALLATION DATE REQUEST ��
Todays Date� -�' Install Crew: � _�� �
i �
R2qUG5t2d It15t211 02t@: "' (To be determ3ned by Scheduler or�nstaiier Manager)
IIVSTALLATION DATE: 1$l�� Amt.Due @ 3nstatl:
l
( Amt.Due @ SUS:
i ,
Salesperson:
ETA for product(date): 1..V�
Customer Name:
,1 •,� � -� ";I� GL'..�t.r
Site Address: G"�� .� ��:�.,C-- t-r'� ��:, '•.-1---'.
:�-� r`, �
Phone#/Joh 5up/Contact: �� � .' � (vr'`` "' ? �t �- i"+�; ,. : ', /r
Lockbox: ��"���i . REMODfL NEW
Gasline by GHH: {' � Car�et��stretch by GHH: - ;{.'
Electric by GHH: Framing/sheetrack: � _�„_
Sionework by GHH: Core JrFi1'sng:
Cut down ZC Firebox: Exisif�g Fireplace Removal: I
Unit need to be raised??? �
Unit/Location: Uni>/Roorc,/leve! Ur�itjRoom/Levei Unit/RoomJLevel
Tota!Units Forthisjob:� � ' � � �;_'„
i�,�� v t�� .
;�t�. -•a + ?�
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Previe�.v Req�red' �e: � BySaSesPerson/date:
�Yn , By Previewer/date:
SAIESPERSON MUST C�MPLETE TOP HALF OF FORM COMPL£TELY.
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'.ST:,Li.ER NOTES FOR�06: N Q ` (Xj�L 1�/�� G�N"""`V l, ,.,��
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MLDVT=40N1�, 40 Merit DV, Trad, MV, Nat ',
� Serial Number
__.. A.M,�•S. H7516 III III I",II Illli�'I I'I"I II II II"IIIII'I III � Unit:
S6413L4004� �
_ . ' ,.._cD$Y?(CHECK BOX) GLOWING HEARTH �� BUILDER
*�_:SE_:n%°.AM'hi&litDCR ON HOMEOW NER TNF CITY OR CAUMiV WNFRE VERMIT IS Perm it No.:
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--_- i;�PJ SET: Date: �U� r L
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C ^� DATE S TIME
CITY OF ORONO CALLED IN ��7 � �•.3� �
INSPECTION1V(�Tl.��lg� SCHEDULED c�� lS
PERMIT NOolU`j COMPLETED
ADDRESS -���� �-
OWNER • T HON NO.�s�� �a��'��
CONTRACTOR L
� DESCRIPTION -
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tL ❑ FOOTING ❑ DEMO-FINA S FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS �
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT ���
Q ❑ FINAI ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO _ '
� COMMENTS: F�` !��� �f ��r•s������o� �
a �l n�'•L b�e,,,i,5 p�i//e� ri.t� i'10 r�co�d o��.,�p���s�
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W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COYERING PERMANENT
D CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED
INSPECTION REQUIRED_CALL TO ARRANGE ACCESS.
Cail for the next inspection 2a hours in advance. (g52) 249-4600
OwnerlConVactor on site:
Inspector. � eti ��
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMR NO.ab�b 'O�t`�4 COMPLEf . ?�-. ^ �LS�
ADDRESS,1���� ���
OWNER TELEPHONE NO.
CONTRACTOR ��04�ira��rtt �t- �a�e.�
� DESCRIPTION R�• �/'��4�'�2
W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
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 ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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W RKSATISFACTOR�F.PROCEED ❑PROJECTCOMPLEfE
� ❑'CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT 1NORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC04/ERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILI RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector. •–�
White Copyllnspector's File Cenary CopylSite Notks