HomeMy WebLinkAbout2001-P04712 - gas fireplace PERMIT
�'I�i� �� �R�N� Permit Number:
2750 Kelley Parkway - PO Box 66 P04712
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued: i2�i ii2ooi
SITE ADDRESS: 1345 North Arm Dr
MOLJND,MN 55364
PID: 07-117-23-41-0086
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Per►nit Type: Mechanical Permits Permit Sub-type(s): Gas Fireplace
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 40.25 Valuation: $ 3,220.00
State Surcharge Fee: $ 1.61
Misc. Fee: $ 1.50
TOTAL FEE: $ 43.36
APPLICANT: Countryside Heating&Cooling OWNER: H SHEKELS&L SHEKELS TRSTES
65ll Hwy 12 1345 NORTH ARM DR
Maple Plain, MN 55359 MOLTND MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE SUEDBYSIGNATURE
Cooies: 1-File(SiQnitures Reauired). 1-Applicant, 1-Monthlv Revorts. 1-Assessine, 1-Finance p�e �
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CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORNiATION
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 2 working days.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL
YOU RECEIVE 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. Identification of and specifications for water heating equipment
shall also be provided.
4. When any new construction or remodeling is involved, a separate building permit must be obtained.
5. Al_ .:ork must be done in accordance with the Uniform Mechanical Code/State Building Code requirements.
6. Ali �aork must be inspected (rough-in and final). Call 249-4600. 24-hour notice required.
7. House Heating Test Record must be submitted before final.
Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification.
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 249-4600.
Please check one: New ✓�Addition Repair Replace
�Residential �Commercial
JOB SITE:�345 NpcZ�N AR y1•` pR , Zip: S 53��
Owner's Name: S���:: s N��..�L� Telephone Number: g S�.-4��- �S��
Mailing Address: S/���n t= City: Zip:
Contractor's Name: `��r,,-cc�,�,5��e t-t��,-�c�C� Telephone Number: �i�:� -�}-�� -1���
Mailing Address: (E,�i� N�.0 p`r i z— City: M�p�C C�►•��Zip: S S 35�1
SYSTEM DESCRIPTION
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTUs:
Output BTUs:
CFM: ='
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COOLI�G SYSTEMS =
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Quantity: �
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Make:
Model:
Tons:
H. Power
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FIREPLACES
as factory fireplace
Wood burning factory fireplace with flue
Wood Stove
Wood stove with flue
Brand Name \�"Z`-� �-�E�J� Model No. �'i� �--
VENTILATION
No. Kitchen Exhaust ducted recirculating cfm
No. Bath Exhaust (must be ducted outside) cfm
No. Other Fans: Locations cfm
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
Installation Removal
Fuel oil: gallons underground inside outside
LP Gas: gallons
Other Gas opening
PERMIT FEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($3�.00)
'3 ���.C7 -C� C� x .0125 $ -4 O .��-
(contract price)
2. State Surchar�e. ** Add the State Building Code Division
Surcharge to each permit. a.aO:C�� x .0005 $ '� � �
or $.50, whichever is greater (con ract price)
3. Postage and Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ �13 _��c
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted
�- 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, labor, or installation 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 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 of the contract price under$1,000,000 or $.50 - whichever is greater.
For valuations over $1,000,000 call the Department of Inspectional Services for the price.
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 Minnesota
State Building Code, and certifies that all statements made on this application are complete, true
and correct.
Applicant's Signature: -- Date: �a--�� '��
� Approved By: Date: r
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