HomeMy WebLinkAbout2005-P08719 - gas fireplace « � •• PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P08719
Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits
(952) 249-4600 Date Issued: 5/12/2005
SITE ADDRESS: 345 North Arm La
Mound,MN 55364
PID: 06-117-23-24-0015
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Sub-type(s): Gas Fireplace
Permit Type: Mechanical Permits
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 77•49 Va�uation: $ 6,199.00
State Surcharge Fee: $ 3.10
TOTAL FEE: $ 80.59
APPLICANT: Woodland Stoves&Fireplaces OWNER: David&Carla Sipprell
1203 Washington Ave. S. 345 North Arm La
Ivlinneapolis,MN 55415 Mound,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 CO QUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNA
Copies: 1-File(Si�nituresRequired), 1-Anvlicant, 1-MonthlvRevorts, I-Assessing, 1-Finance Page 1
� � ' .
FOR CITY USE ONLY
Q City of Orono
„i;�� �(+�� P U.B�x bb Date Received: Nermit#
t:i }� 2750 Kelley Parkway
��" ��A`^ !-j Crystal Bay,MN»323 Approved By: Amoimt$:
�'��,P�+%% (9�2)2�49-4600
CITY OF ORONO-MEC��ANICAL PERMIT
(All Commeroial pennits must be approved b}the Building Of3icial or lnspector and/or Fire Mazshall)
GENERAL INFORMATION
1. You may apply for mechanical permits by mait or in person at the City offices. Applications will
be reviewed and a permit will be issued within two working days.
3. Yermit cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WOI21C MUS'T NOT BEG1N UNTIL THE
YERMIT CA12D lS YOSTED ON THE JOB SITE
3. Mechanical Desi�ns—Complete calculations,details and specifications are required for each
heating,ventilation,h�unidit7cation-dehumidification,and air conditioning installation including
heat loss/heat gain calculation,design temperatures,equipment ratu�gs and identification as to
type,manufacturer and model. Data shall be presented on form provided.
4. When any ne�v construction or remodeling is involved,.a separate building permit must be
obtained. '
�. All work must be done in accorciance with the Ur�iform Mechanicat Code/State Building Code
requirements.
6. All work must be inspected(rough-in and final). Call(952)249-4600.
(24-�t8 liour notice required)
7. House Heating Test Record must be submitted before final.
TYYE OF PERMIT
Check All That A 1
Resideutial ❑Commercial(Approval Renuireci)
❑ New ❑Additional ❑Repairs ❑Replace
Job Site/Owner Information:
Site Address: d , ;� �
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Owner: '� � � �_L Mailing Address: �r) �,�C.�( �j ,
Cit}': ���-DYl(i Zip: ��j , �
Home Phone: ��� - ����_��� Alternate Phone:
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Contractor lnformation:
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Contractor: �.��j,�1-Y�p ����� Contact Person: \Yl ►� �-
Address: ��'3 �1�4�� /�(,1��ate Bond#: ��-� C'SD�-�$ � �-
City: ���-� Zip:�'��5 Expiration Date: �� � � � �CO j
Phone: ��`����-�'�--� Alternate Phone: �P�a-��� ������
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❑ Insuranee-Current: .��P-&� ��j��
1 ��� s�a�������
, �
�� ME�HANICt�L SY�TEMS BEING INSTALLED
HEATING SYSTEMS
Quautity:
Mal:e:
ModeL
Fuel:
Flue Size:
Input B1'Us:
Output BTUs
CFM:
COOLING SYSTEMS �
Quantity:
Make:
Model:
Tons:
H.Power
FIREYLACES
❑ Gas Factory Fireplace
❑ Wood Burning Fireplace
� Wood Stove
Wood Stove With Flue
Brand Name: Model No.:���� —��"L;T�t
VEN'TILATION
❑ No. Kitchen Exhaust duct recirculating cfm
❑ No. Bath Ext�aust(must have duct outside) cfm
❑ No. Other Fa�is: Locations ��
FUEL S'CORAGE(MUST BE APPROVED BY FIRE MARSHALL)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Oiher/List What&Where:
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� PERMIT FEE CAI,CULATION(S)
BASED OFF-2002 STATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture or ap�liance that meets all three of the followiug requirements:
1. Does not require modification to electricai or gas service.
2. Has a total cost of$500.00 or less; exc(udin�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 $ .50
Mail-In Fee(If Applicable) $ L50
Totai Yermit Fee $
PERMIT FBE CALCULATION(S)-JOBS OVER$SQ0.00
If above does not apply; follow guidelines below: .
1. CONTRACT PRICE * is 125°l0 of contraci price with a(Miui►nwn Fee of$35.00)
�, l�l�?. OC� X.oi�s� '�-�k �
(wnvact price) (minitnum$3�.00)
2. STaTE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fec of$.50)
�, /��� �U x .0005 $ �� I �
(conuxct price) (mioimum$ .�0)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
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4. TOTAL YERMIT FEE(Add Lines 1-3 Above) $ �q�
• * CONTRACT PR10E or JOB COST means the actual or estiinated doltar amount charged for the
pzrmitted work including materials, labor, profit,and other fixed costs. It is the amoiuit to be charged
to the customer for the work done. If any material, equipment, labor or installations are furnished by
the owner, t�nant 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.
■ **1'he STATE SURCHARGE is.0005 of the Buildi��g Department at(952)249-�600 for the price.
[-T� MECHA.NICAL PERMIT APPLICATION AGREEMENT
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 cei•tifies that all statements made on this application are camplete, true and
correct.
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Applicant's Signature: �'��-� /� �`�-� Date: �� �b
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