HomeMy WebLinkAbout2017-00587 - gas fireplace ` ' CITY OF ORONO
2750 KELLEY PARKWAY * 2 0 1 7 - 0 0 5 8 7 *
DATE ISSUED: 06/OU2017
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 1220 LYMAN AVE
PIN : 35-118-23-34-0016
LEGAL DESC : LYMAN WOODS
: LOT 003 BLOCK 001
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 4,185.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
HHT GAS FACTORY FIREPLACE
APPLICANT MECHANICAL 52.31
STATE SURCHARGE MECH(VALUATION) 2.09
FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00
2700 FAIRVIEW AVE
ROSEVILLE,MN 55113 TOTAL 56.40
(651)633-2561 Payment(s)
Minnesota State License#:mech-20512060 CREDIT CARD 4616 56.40
OWNER
BENSON, SEAN&ALISA
1220 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 Ciry 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 construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of l80 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
revoked at any time for due cause.
� �/ �l / /7
Applicant Permitee Signature Date Issued B gnature Date
05-31-'17 11 :41 FROM- T-284 P0001/0404 F-558
��r�f�`fi ll (— vVVi
FO�i X UST ON[.Y
�ry�� CiCy of Orono � , permis# (�/� / ��O �
�✓ P.O.Box 66 Dat�Rec
2750 i.elley Parkway
Crystel Say,MN 55323 ApproVed By: AmOunt$:�L
Phone(952)249-4600 Fax(952)249-0616
'`y�, ��
1.{k�s�pQ,��' CIT'Y'OF ORONO—1VIECkIATVICAL PE1tMIT
(A11 Commercial pelrolits rtulst Dn approve:G by[he Builaing o�cial or Inspector and/or Firo Mafshall)
CxEN�RAG INFORMATION
1. You may appl�+for mechanical permits by mail or in person at the City offices. Applications will
be reviewed and a permit will be is3ued within two working days.
2_ Permit cards will be sent by retum mail after a rtview is completed. PERMITS ARE N'OT
VALID UNTIL Y4U R�CENB A pERMYT. WORK MUST NOT BEGIN UNTIL T�T�
PERMIT CARD IS POST�D ON'TH��O�SYTE.
3. Mechanical Dcsiens—Complete calculations,details and specifications are required for esach
heating,ventilation,humidification-dehumidification,arld air conditioning installation including
heat loss/heat gain caiculation,design tcmperatures,equipment ratings and identification as to
type,manufacttuer and modtl. Data shall be present�cl on form provided.
4. When any neW ConstruCtiott or remodeling is involved,a separate building peCmit mUst be
obtained.
S. AlI work must 4e done in accordance with the Uniform MechsnicAl Code/State Building Code
rcquircmcnts.
6. All'work must bc inspected(rough-in arld flnal). Cali(952)249-4600.
(24-48 hour notice require�
7. �Touse Neating Test Rccord must be submittzd before final.
T'�E OF PERMXT
{Check All Ti�at A ply)
,�Residential ❑Commercial(Approval Required)
l \
❑Ncw ❑Additional ❑Rtpairs �Replace
Job Site/Ovvner Ynformation:
Site Address: f�'�a �'��'� ���
�> So� a a 5'��
Owner: ���� � ��� S� rJ�ailing Address: .'�a w`� S ►
City: W�'�� �� Zip: �J'�^��
Home Phone: /�����y�0�ternate Phone:
Contractor Tnformation:
Contractor; �IRESIDE HEARTM& HOME Cont�ct�erson; .����
Address: 2700 Fairview Ave N State Bond#:BC662656, MB662572, PC662571 �
���,; Roseville, MN Z�p 55113 ��p�ration Date:
Phone: GO✓'�I�(,8?J0�.3��lD A[ternate Phone: ��`������12'
❑ Insurance—Current:
1
45-31-'17 11 :41 FROM- T-284 P0002/0004 F-558
.
' ;,':; `: .:::. . : ... .. . <MhCHAN�CA�'SY'�TEMS'BEiNG�1NST�T;��D, ,,:, �,': ,' : .;. ' ,
Note:All Geothermal Systems wi1N now require a Sife Plan&Review b�our$uilding Official.
IS THIS G�4T.�Y�XtMAY,$ ❑Yes ❑No
HEATING SYST�IV�S
Quantity:
Make:
Model:
�ueL-
�'lue Size:
Input�TUs:
Output BTUs:
C�'M:
COO�,ING SYSTEMS
Quantiry:
Make:
Modtl:
Tons:
�T.Power
�'l�i�pX,AC�S
� Gras�actory Fireplace Brand Name: t/ / +
❑❑ Wood Burning Fireplace ��,G� �,��
Wood Stove Model No.:
❑ Wood Stove with Rlue/Masonry
v�rrxrr,nrYON
❑ No. TCitehen�xhatast duct reeireulating cfm
❑ No. Bath B�chaust(must havo duct outside) cfm
❑ No_ Other Fans: �,ocations cfm
�C1�X,STORAG� (Mrrst be approved by Pire A�nrsl:aU�jproposing to nbnndon tank in pl'ace.)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Undcrground ❑Tnside []Outside
�,P Gas: gallons
Other:
GAS LY1VL�01VX.'Y
❑ Outdoor Grill ❑ 4ther/Y,ist Wha�&Whtrc:
2
05-31-'17 11 :41 FROM- T-284 P0003/0004 F-558
` '� `�ERMIT;��E�,CA'C,CUL TION S ,;.
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,���. � )-�.
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��; �b:OFF:'=20'2`S ATE;S'�A`r`CJE:`
S� 0 T
$�. �;�
❑ Yes,this section applies
Thc rcplaccmcnt of a Residential fixture or a liAnce that meets all three of the foilo�ving requirements:
1. Doe3 not require madification to electrical or gas service.
Z. �Tas a total eost of$500.00 or fess;exeludin the cost ofthe fixture or appliance:and
3. Is improved,installed or replaeed by the homeowncr or licensed contractor.
Skip next section,if this applies; Cost of permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(�f Applieable) $ 2.00
Tota1�ermit Fee $
�� ��:.pLRMIT.FEE;CAliCULATION(S.)`��.�OBS;Q'V�1Z..$5.00;00.;;�:��'";;`':";::;::;�:;;:;:�;.
If above does not apply;follow guidelines below:
1. CO1VT�tA,CT pRYC� '"is 1.25%of contract price with a(Minimum Fee of$50.00) �
/ � X.o�zs$ 52. �
( ntrsC[priCC) (minimum$30_00)
2. STATE SURCHARGE ��
� x.0005 $ �'
(ontract price)
3. POSTACrB&HANDLING(Only on Mail-Yn Applications) $ �
�� �� .�
4. TOTAL PERM�T Y���(Add X,ines 1-3 Above) $ /• �
■ '� CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for thc
permitted work including msttrials,labor,profit,and other fixed costs. It rs the amount to bz charged
Eo thz customer for the work done. If any material,equipment,labor or installations 1re furnished by
the owner,tenant or any other party,the reasonable market valuc of such items must be added to the
estimated cost or contraet priee for permit fee purposes. Tn the cvent that there is a dispute on the
amount of the job cost, the City may requzst the submission of a signcd eop�of the aetual eontract.
;.,.;..;•.:.;,.:.:
.;:;:,.�... . . .. .
. . ` :;11!�ECHAI�IIGA.Is;PER1VIITiAPPZ;ICA'Y`�ION�AG��11itENT>;:,`�;`.''r.;:�;;;`.;:.::.::�,'.:;; i`
'X'he undersigned hereby applies to the City for issuance of a Mechanical Permit,agrees to do all
'work in strict accordance with the ordinances of e ity and the regulations of the Sfate of
Minnesota, and certifies that all stateme m e r� this applieation �re co�►plete, true and
co�rect.
Applicant's Signature: - �� - - Date: �f� ��/�
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