HomeMy WebLinkAbout2014-00041 - gas fireplace , . „ CITY OF ORONO * z 0 1 4 - 0 0 0 4 1 *
2750 KELLEY PARKWAY DATE ISSUED: Ol/14/2014
ORONO,MN 55356-
952) 249-4600 FAX: (952 249-4616
ADDRESS : 2435 NORTH SHORE DR
PIN : 09-117-23-44-0010
LEGAL DESC : SCOTCH PINE ADDN
: LOT 003 BLOCK 001
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 12,000.00
NOTE: HEAT N GLO TRUE 50 AND REVENT EXISTIN GAS FIREPLACE
APPLICANT MECHANICAL 150.00
STATE SURCHARGE MECH(VALUATION) 6.00
FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00
2700 FAIRVIEW AVE
ROSEVILLE,MN 55113 MISC FEE 0.00
(651)633-2561 TOTAL 158.00
Minnesota State License#:mech-20512060 Payment(s)
CHECK 2003400 158.00
OWNER
HOUDE, MR.
2435 NORTH SHORE DR
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 sepazate
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 180 days at any time after work has commenced.
The applicant is responsible for assuring aIl required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Issued By nature Date
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FOR CITY USE ONLY
�O A TO City of Orono
<y P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By: Amount S:
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Phone(952)249-4600 Fa�c(952)249-4616
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��kESH���` CITY OF ORONO—MECHANICAL PERMIT
(All Commercial parmits must be approved by the Building�cial or Inspector and/or Fire Marshall)
GENERAL INFORMATION
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
VALID UNTIL YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SiTE.
3. Mechanical Desians—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 construction or remodeling is involved,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 6our notice required)
7. House Hearing Test Record must be submitted before final.
TYPE OF PERMIT �
Check All That A 1
�J Residential ❑Commercial(Approval Required)
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�New ❑Additional ❑Repairs [�Replace
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Job Site/Owner Information:
� SiteAddress: 0����5� /YO��hS�ofG I�]�•
Owner: �D 1/O�'C, Mailing Address: �y3 S� /�nr��Shv�� Q�',
c�ry: t--��Y Z`��- rNN z�p: SS 3 �/
Home Yhone: Alternate Phone: �n� a�- o�g� " �� ��
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Contractor Information:
Contractor: Contact Person: HEARTH &HOME TECHNOLOGIES
dba FIRESIDE HEARTH &HOME
Address: State Bond#: Lic BC662656
NUE N
City: Zip: Expiration Date: NQSEVILLE, M��5113
Phone: Alternate Phone:
❑ Insurance—Current:
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MECHAIrTICAL SYSTEMS BEING INSTALLED
Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes ❑No
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTCJs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES � �'r P(�L�
�,Il(�` C�� SO �e' Vtn�- ejtis�i� G.S i G
�. Gas Factory Fireplace Brand Name: �ta�n (�� o
❑ Wood Buming Fireplace ,��
❑ Wood Stove Model No.: / F N� _��
❑ Wood Stove with Flue/Masonry
VENTILATION
❑ No. Kitchen E�chaust duct recirculating cfm
❑ No. Bath E�chaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be appmved by Fire MarshaU if proposing to abandon tank in plac�)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
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PERMIT FEE GALCULATI4N(S}'
BASED OFF -2002 STATE STATUE '
❑ Yes,this section applies
T'he replacement of a Residential fiacture or appliance that meets all three of the following requirements:
1. Dces not require modification to electrical or gas service.
2. Has a to cost of$500.00 or less;excluding the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip neact section,if this applies; Cost of Pernvt $ 15.00
State Surchazge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
PER�LIIT FEE CALCULATION S —JOBS OVER$SOQ.fl(?
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1_25%of contract price with a(Minimum Fee of$50.00)
��,(yl1L). vt� x.0125$ �5d. ��
(con ct price) (minimum$50.00)
2. STATE SURCHARGE
�aZ(Tll�• lit, x.0005 $ �•��
( tract price)
3. POSTAGE&HANDLING(On(y on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �.5 a • �v
• * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials,labor,protit, and other fixed costs. lt is the amount to be charged
to the customer for the work done. If any material, equipment, labor 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 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.
' MECHANICAL PERMIT APPLI�ATION AGxtEEMENT
The undersigned hereby applies to the City for issuance of a Mechanical Pernut, 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: �� � Date: � .3
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CITY O ONO CALLED IN I 'Z -�
INSPECTION OTIC SCHEDULED - - .1�'3Q
PERMIT NO. � COMPLETED �
ADDRESS � �� �DY�. �'/'/ L/t�
OWNER ' TELEPHONE NO. �a' ' �7
CONTRACTOR L
� DESCRIPTION ^ �'` `�� / L R �
� ❑ FOOTING ❑ PLUMBING FINAL p EXCAV/G DING/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE � SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v � DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
i ❑ DEMO-FINAL � SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
2 OWNERfCOMRACTOR TO MEET YipU�ES_Np
� COMMENTS: �
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� �WORK SATISFACTORY:PROCEED O PROJECT COMPLETE
ECT VYORK&PROCEED O ISSUE CERTIFICATE OF OCCUPANCY
� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTO TAKEN
INSPECTOR WFLL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS.
Ca11 forthe next inspection 24 hours in advance. (952) 249-4600
OwnerfContractor on si�e:
Inspector:
White Copyllnapecto�'s File Canary CopylSfte Notke
, INSPECTION NOTICE ✓
/ ��. DATE TIME
CITY OF 1���� CALLED-IN
ODD � SCHEDULED �� �l�
PERMIT NO. a�� � co PLET �
ADDRESS �`���� �� � " �
OWNER/CONTR. ���D � '" ��'
❑SITE INSPECTION ❑MECHANICAL RI ❑ REINSPECTION
❑CONG SLABS ❑MECHANICAL FINAL ❑ FOLLOW-UP
❑ FOOTING ❑INSULATION ❑COMPLAINT
❑ POURED WALL �O 13A`fED ASSEMBLY ❑ FIREPLACE
❑FOUND. DRAINAGE �F3UILDING FINAL ❑SPRINKLER SYSTEM
❑ FRAMING �❑:4EPTIC INSTALL ❑
� ❑SHEATHING ❑SEPTIC FINAL ❑
❑ PLUMBING RI ❑S&W HOOKUP ❑
� �PLUMBING FINAL ❑GAS LINE MANOMETER ❑
o COMMENTS:
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� FURTHER CORRECTIONS MAY BE REQUIRED ❑ PERMIT FINALED
� ❑ WORK SATISFACTORY: PROCEED ❑ PHOTO TAKEN
O ❑ CORRECT WORK& PROCEED
U ❑ CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
❑ CORRECT UNSAFE CONDITION IMMEDIATELY.
❑ STOP ORDER POSTED. CALL INSPECTOR
❑ INSPECTION REQUIRED. CALL TO ARRANGE ACCESS.
TO SCHEDULE YOUR INSPECTIONS
PLEASE CALL: (763) 479-1720
Metro West Inspection ervices Inc. -
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Owner/Contr. on site: �
Inspector: /
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