HomeMy WebLinkAbout2010-01136 - gas fireplace CITY OF ORONO PERMIT NO.: 2010-01136
2750 KELLEY PARKWAY
` ORONO, MN 55356- DATE ISSUED: 1 U18/2010
� 952 249-4600 FAX: 952 249-4616
ADDRESS : 60 MYRTLEWOOD RD
PIN : 36-118-23-33-0020
LEGAL DESC : REG. LAND SURVEY NO.0446
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 1,900.00
NOTE: 1 HEAT N GLO FACTORY GAS FP
APPLICANT MECHANICAL 50.00
AMERICAN AIR SUPPLY, INC. STATE SURCHARGE MECH(VALUATION) 5.00
11257 207TH AVE NW
ELK RIVER,MN 55330 MAIL-IN FEE 2.00
(612)282-7568 MISC FEE 0.00
TOTAL 57.00
OWNER
HARTMAN,TODD
60 MYRTLEWOOD RD
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 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 aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
' " _ _ ' c,.�.`— / / / /
Applicant Permitee Signature Date Issued By nature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
FOR CITY USE ONLY
, � O¢��� City of Orono
P.O.Box 66 Date Received: PermiY#
2750 Kelley Parkway
� ,�+''• � Crystal Bay,MN 55323 Approved By: Amount$:
� ���:�• '.�o,. Phone(952)249-4600 Fax(952)249-4616
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CITY OF ORONO—MECHANICAL PERMIT
(All Commercial permits must bc approved by the Building Official or Inspector and/or Fire Marshall)
GENERAL 1NFORMATION
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
VAL[D UNTIL YOU RECE[VE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desiens—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 cunstruction or remodeling is invoived,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 hour 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: 6� My1��eWOOC� ROaC�
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
American Air Supply John DoBrava
Contractor: Contact Person:
11257 207thAve NW 69588053
Address: State Bond #:
c;�,: Elk River Z�p:55330 Expiration Date: � ' �9 ' ��
Phone: (612� 282-756H Alternate Phone:
❑ Insurance—Current: belClg S@Clt
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Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes 0 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 Br�,a Na,Y,e: heat-n-glo
Wood Burning Fireplace Montana log
Wood Stove Model No.:
Wood Stove With Flue
VENTILATION
No. Kitchen Exhaust duct recirculating cfm
No. Bath Exhaust(must have duct outside) cfm
No. Other Fans: Locations cfin
FUEL STORAGE (Must be approved by Fire Marsha[l 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: GaS IOg OCl flat 1'OOf
2
� 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 filcture 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 $
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If above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00)
1900 X.o12s $ 50.00
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee ofS5.00)
1 ,900.00 X.000s $5.00
(contract price) (minimum$5.00)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $57.��
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount chazged for the
permitted work including materials, labor,profit,and other fixed costs. It is the amount to be chazged
to the customer for the work done. If any material, equipment, labor or installations aze 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 times the Contract Price or a minimum of$5.00.
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: 1 '/6� Date: 11-15-�O
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