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Home My WebLink About2012-00989 - gas fireplace . CITY OF ORONO * Z 0 1 2 — 0 fd 9 8 9 * 2750 KELLEY PARKWAY DATE ISSUED: 10/04/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3458 NORTH SHORE DR P[N : 08-117-23-43-0025 LEGAL DESC : LYD[ARDS PARK LAKE MTKA : LOT 019 BLOCK 000 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIREPLACE-GAS VALUATION : $ 5,000.00 NOTE: HEAT N'GLO SLSSOTRS APPLICANT MECHAN[CAL 62.50 COUNTRYSIDE HEATING& COOLING STATE SURCHARGE MECH(VALUATION) 2.50 6511 HWY 12 TOTAL 65.00 MAPLE PLAIN,MN 55359 (763)479-1600 OWNER LINDBLOOM, MARY& DEAN 3458 NORTH SHORE DR WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed accordin�to the approved plans and specitications,applicable Ciry 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 afrer work has commenced. The applicant is responsible for assuring all required inspections are requested�conformanae with the State Building Code.This permit may be revoked;�a�)/any time or d cause. ,\//� � / /LG_J ' `�'`�v� /� / L' � �-� � � 4'7`,. �.�.. �...' L..YY�L= i'"'� � �r`� .._�^ � Applicant Permitee S�gnature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. i � 1 FOR CITY USE ONLY �O¢��O City of Orono P.O.Box 66 Date Received: Pemut# �;. 2750 Kelley Parkway j'�'� �*'�,. �� Crystal Bay,MN 55323 Approved By: Amount$: ��? ��:;�.�o�%� Phone(952)249-4600 Fax(952)249-4616 ��s� CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits must be approved by the Building Official 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 Desiens—Complete calculations,details and specifications are reyuired 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 ar 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 hour notice required) 7. House Heating Test Record must be submitted before final. TYPE OF PERMIT Check All That A 1 0 Residential ❑Commercial(Approval Required) ❑ New ❑Additional ❑ Repairs ❑Replace Job Site/Owner Information: site Aciclress: 3458 NORTH SHORE DR WAYZATA MN 55391 Owner: D EAN L I N D B LOO M Mailing Address: SAM E City: Zip: Home Phone: Alternate Phone: Contractor Information: 7—tNc�+i��c �i �i �, COUNTRYSIDESERVICES � � Irina Levin Contractor: Contact Person: Address: 6511 HWy 12 state Bond#: MB005313 Ciry: Maple Plain Zlp: 55359 Expiration Date: OGI3O��4 Phone: (763� 479-1600 Alternate Phone: ❑ AmTrustNorthAmerica X Insurance—Current: 1 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 BTUs: Output BTUs: CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: H.Power FIREPLACES 0 Gas Factory Fireplace Brand Name: H2at Il�C7�0 ❑ Wood Burning Fireplace SL550TRS ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTILATION ❑ No. Kitchen Exhaust duct recirculating cfm ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (Must be approved by Fire Marshall 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: 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;excludin¢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 $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ If above does not apply;follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) 5,000.00 X.o12s$ 62.50 (contract price) (minimum SS0.00) 2. STATE SURCHARGE rj,OOO.00 Z.�JO x.0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $65.�� ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollaz 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 installations are furnished by the owner, tenant or any other party, the reasonable mazket 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 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: i�%� Date: 1 O/O2/1 Z „ , � 3 �_7 C� DATE TIME CITY OF ORONO CALLED IN /(�I 7-/�' INSPECTION T C o SCWEDULED /,(�-/�/� � PERMIT NO. � b� C MPL ED ADDR � � �-- �/`� OWNER PHON .�1� ��—� CONTRACTOR � DESCRIPTION ^ � ti� I � ❑ FOOTING PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING v1ECHANICAL FINAL O ❑ 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 _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PL ING RI ❑ SEPTIC FINA� ❑ FOUNDATION/REMOVAL OWNE TRACTOR TO MEET YOU:_YES NO v, COMMENTS: � W a o \ Q c I 1 '�� '� / c� � ( — ( � � 0 � W � Q � 2 W � W � � � d W� ❑WORK SATISFACTORY:PROCEED �WOJECT COMPLETE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WlLL RETURN ❑STOPORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�0 OwnerlConUactor on site: Inspector. White CopyllnspecloPs File Canary CopylSite Notice