HomeMy WebLinkAbout2004-P07716 - gas line inspection CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Po��16
Cr�stal Bay, Minnesota 55323 Per'mit Type: 1vlechanical Permits
(952) 249-4600 Date Issued: �ii6i2ooa
SITE ADDRESS: 3587 North Shore Dr
WAYZATA,MN 55391
PID: 08-117-23-34-0056
DESCRIPTION:
Proposed Use: Residential
Pernut Class: General
Permit Type: Mechanical Permits Permit Sub-type(s): Gas Line Inspection
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Post grill with new gas line
FEE SUMMARY: Pernut Fee: $ 35.00 valuation: $ 920.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: Allied Fireside(See Comments) OWNER: S R&7 S Si7NDBY
DBA:Fireside Hearth&Home 3587 NORTH SHORE DR
2700 Fairview WAYZATA MN 55391
Roseville,MN 55113
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AG ES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
M '�' L IN� ODE REQUIREM
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P ICANT PERMITE SI ATURE I UED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Applicant. 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
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, �ITY OF ORONO APPLICATION FOR MECHANICAL PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be
reviewed and a pernut will be issued within two working days.
2. Permit cards will be sent Uy return mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU R�CEIVE A PERMIT. WORK MUST NOT BEGIN LTNTIL THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Mechanical Desi ns-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 Ue 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 pernlit must be obtained.
5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code
requirements.
6. All work must Ue inspected (rough-in and final). Call (952) 249-4600. 24-hour notice required.
7. House Heating Test Record must Ue suUmitted 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
(952) 249-4600.
Please check one: ❑ New ❑ Addition ❑ Repair �Replace ❑ Residential ❑ Commercial
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JOB SITE: '_�`;� � ���%/I�� �i ���G��� Zip: :5-s�.�'R'/
Owner's Name: ���7 �j N � ; Phone Number: ���--y�'/- �j,��
Mailing Address: s¢vr1�' City: Zip•
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�l�'�i� �FA�i�� ����
Contractor's Name: Phone �umber: �a_j���,�.3����
Mailing Address:� �d� �iQ/QJ��=c City: c�%; Zip: �5�//�
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SYSTEM DESCRIPTION • .
uE�TiA1G S�ST�]YIS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTtJs:
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES GAS LINE ONLY
�Gas�actory-€'�ee—��5��C.?�C/,L 4, �! � ❑ Installing a Gas Line Only
Wood burning factory fireplace with flue
❑ Wood Stove ��� �S �!��`
�_., ❑
Wood stove with flue
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Brand Name 01�� ��¢%L Model No.
VENTILATION
No. Kitchen Exhaust duct recalculating cfm
No. Bath Exhaust(must have duct outside) cfm
No. Other Fans: Locations cfm
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
❑ Installation or ❑ Removal
❑ Fuel oil: gallons ❑ underground ❑ inside �tside
❑ LP Gas: gallons
❑ Other Gas opening
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� PERMIT FEE CALCULATION(S)
2002 State Statute ❑ 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; excludinQ the cost of the fixture or appliance:
and
3) Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee $ 1.50
If aUove does not apply,follow guidelines below:
1. Contract Price* is .0125%of joU with a Minimum Fee of($35.00)
� � x .0125 $
contract price) (minimum$35.00)
2. State Surchar�e. ** Add the State Building Code Division a Minimum Fee of($ .50)
x .0005 $
(contract price) (minimum� .50)
3. PostaEe and Handlin�(Orily fnail-iri applicatioris) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 aUove) $
*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. [f any material,
equipment,labor,or installation is 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 t 'ty for i suance of a Mechanical Permit,agrees to do all work in strict accordance with
the ordinances of the City and the r gula i s of t inn ta State Building Code,a rtifies that all statements made on this
application are compl ,true an orre t.
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Applicant's Signature: �•C-�-�—' Date: t"�' e!/
Approved By: Date:
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HOUSE- HEATING TEST RECORD
ADDRESS -�S� � N.�Qi'I��.I�.9i APT. FLOOR CITY ���
OCCUPANT � OWNER , �`���C_
HEAT Lr055 � G DATE HTG. INST.
t�OI.D BY �� ��uF'.�6 v�ic�rFR INSTALLED BY /:
El�ctrieol Work By_,,��/�/,S �� F[F�'77�'/C Gos Lin� By—— � �//���c�\/ �( ^�P�
TYPE OF HEAT GA FA,�HW STEAM SPACE HTR. UNIT HTR. OTHER.
GAS DESIGN CONVERSION
MAKE � "-�- ,���L1 MAKE OF BURNER ���
Mod�l y G ryi��/ Irbdel
S�riol — - - ��__,.— Mox. BTU Rofine
INPUT �s�0 `— MAKE OF FURNACE _ ����" �
�,asi �Y/�
CONTROLS �
THERMOSTAT __G�_ Hwt Piuy � VMt Sizs `�
Valv� �/l�l/ _ ��`��y S
--,- KIND OF UNER_!r1 SIZE.�_NONE
Lin�it_ �/� Droh Hood o��'�
Regularor
Limit S�tfiny - l�� Filt�rs Size �d�-r�'� Number-_
Fan S�ttiny `i � C}►imn�y Location Insid� � Outside
Pilot Typ��CS�� �v� Qiimn�y Construction �'"/�F �
Pilot Mok.
Pilot Mod�l �✓t�/� ��e'% Sewke Bomb ��
/ ''� Wi►iny
Pilot Timiny � -/T���,jr�L� Draft �' T�st Tap `�
L.M�. Cut Off Dow Prsssur� �" Liphtiny I�st. �_c
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Phssuti -�-r _P�rc�nt CO 6� Oo» T�st�d c+�`� .�^ �r�/ •
Input CFM _ �r P�te�nt Q� 1�% Co,�yw�r T•sr�ny
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