HomeMy WebLinkAbout2016-01583 - gas fireplace CITY OF ORONO 111111111111111111 111111111 1111111111
* 2016 - 01583 *
2750 KELLEY PARKWAY DATE ISSUED: 01/03/2017
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1175 MOONEY LAKE DR
PIN : 25-118-23-41-0017
LEGAL DESC : MOONEY LAKE PRESERVE
: LOT 8 BLOCK 1
PERMIT TYPE : MECHANICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 13,835.00
NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION.
NEW:(2)GAS FACTORY FIREPLACES
APPLICANT MECHANICAL 172.94
STATE SURCHARGE MECH(VALUATION) 6.92
FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00
2700 FAIRVIEW AVE
ROSEVILLE,MN 55113 TOTAL 181.86
(651)633-2561 Payment(s)
Minnesota State License#:mech-20512060 CREDIT CARD 4616 181.86
OWNER
ADELMAN,TIMOTHY
4545 TRILLIUM DRIVE
MEDINA,MN 55340-
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 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 after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
Applicant Permitee Signature Date Issued By Signature Date
12-30-'16 13:34 FROM- T-629 P0001/0004 F-758
.s1 o523B , 000 /
• 05tiq iF CITY Si ONLY
City of Orono
�30 P.O.Box 66 Date Recei ! 2O/ rmit q �p— 61/,.54-3
2750 Kelley Parkway . / Gn/'
Crystal Bay,MN 55323 Approved By: A�, I Amount$:/
` Phone(952)249-4600 Fax(952)249-4616
,e�KEStiO�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 RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
I Mechanical Designs—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 hour notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PERMIT
(Check All That Apply)
Residential D Commercial(Approval Required)
New ❑Additional ❑Repairs 0 Replace
Job Site/Owner Information: bri Address: Marmoi/ '"' LJ►�i -
Owner:(l(,l,Alr(-try C Co- Mailing Address: /SZ 5-0 2,31-a kit iki
City: P/irvi0' Zip: s'5-Li`7 7
Home Phone: Le(7-' 333-zo 2-O Alternate Phone:
Contractor Information; I�
Contractor: FIRESIDE HEARTH & HOME Contact Person: ' b v'f'-",4/
Address: 2700 Fairview Ave N State Bond ft:BC662656, MI3662572, PC662571
City: Roseville, MN Zip:55113 Expiration Date: II ,, -
Phone: 651-633-2561 Alternate Phone: U�1— U Q
3o Le
❑ Insurance—Current:
1
12-30—'16 13:34 FROM— T-629 P0002/0004 F-758
•
. ;MECHANIC is S M B INC TNSTALI✓:ED,,,. a,'. .. :,,, �`
Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑Yes El No
HEATING SYSTEMS
Quantity: I
Make; I ! 1 ("`-
Model: tC -72XX 1 -c~3(e
Fuel: &a
Flue Site:
Input ETus; 646-60 1/6/6°D
Output BTUs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
c* Gas Factory Fireplace Brand Name: H T
`"LJ Wood Burning Fireplace
IDWood Stove Model No.: or-Ave- 77 4'
Q 'L
❑ . 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
El Outdoor Grill ❑ Other/List What&Where:
2
' 12-30-'16 13:34 FROM- T-629 P0003/0004 F-758
i `PERMIT FE.E CALctj A''JQN(g ,t ,, ;
\ ' , '.BA'SFD QFF:�.2O,Q2 STA A.,$TAT .:��, , .
[] Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
I. Does not require modification to electrical or gas service.
2. Has a total 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 next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
,i ,;,• OE)0VIIT FEE'.CAL4.t;VA: ' QN(S),0OBS.`QVP,RilSQ0 00V, '
If above does not apply;follow guidelines below:
1. CONTRACT PRICE a is 1.25%of contract price with a(Minimum Fee of$r5�0,00)
/3835— x.0125$ /�7Z. LI
(contract price) (minimum$50,00)
2. STATE SURCHARGE / 3 U V x.0005 $ l.L�3 qZ
e
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ Wt
4, TOTAL PERMIT FEE(Add Lines 1-3 Above) $ n - 56, A �'t
■ * 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 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.
NEt~HANICA;:PEI MIVA1400ATXO14;:A.GrRMO.I 7` .
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.
4///,
Applicant's Signature: 4_ ,,,,, Date: 1 3 d [
3
I - 3 * c-/-
/— DATThy E 7 TIME
/
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED /-a/p l7 /1-
PERMIT NO. -D/5TJ. 7 COMPLETED
ADDRESS //75- 1._-k 2)rl
OWNER TENE NO. "?l 3i' ' -1-6
CONTRACTOR - .._�/AAei
EDESCRIPTIONeitifte— - A.-/-e_
ty 0 FOOTING 0 DEMO-FINAL r 0 SEPTIC FINAL
A ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
Z ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
= ❑
F. INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q ❑ FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
W 0 AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
v ❑ DEMO-SITE 0 SEPTIC INSTALL
Z• OWNER/CONTRACTOR TO MEET YOU: YES NO
R COMMENTS:
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W K SATISFACTORY:PROCEED 0 PROJECT COMPLETE
ty ❑ RRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY
C ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on s
Inspector: ii::. .
White CopyAnspector's Filo Canary Copy?SItI Notice
DATE TIME
CITY OF ORONO CALLED IN ���///
INSPECTION NOTICEC SCHEDULED o?— /a ri
e-
PERMIT NO. / )J --,V`)n .)
COMPLETED
ADDRESS // 75 / /a.,/i€ c xJ
r
OWNER • T EPNO.e/ -r3 9-
/go
CONTRACTOR C ( _L4L c . e m
DESCRIPTION J /A-Le/ .4(._
W 0 FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
Z ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
• ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q ❑ FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
Ws. ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
v ❑ DEMO-SITE 0 SEPTIC INSTALL
Q OWNERlCONTRACTOR TOM YOU YES_NO /�
y COMMENTS: C.L F. jetzn 7�sr:r1- - AG�4 - •tCc_c� - CK
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0
0 WORK SATISFACTORY:PROCEED 0 PROJECT COMPLETE
it CGRRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
OO 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector:4 j-1%"--
White Copyfnspectoes Fila Canary Copy/Site Notice
IV
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An Com
fort
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Customer
Address f 1'15 f 1A 000-e y I-6. ki Of
City C9 ro VI (")
Date & i 2 ^ 2d( -7
ACH@50 1 . '7 (Must be 3 or less to pass code)
(Air Changes per Hour at 50 Pascals pressure differential)
Cubic feet of conditioned space 6 / 2 CFM @ l 7050 1 ! 7
p �
Signature of tester .4---\_____- P---x------
Brian Hendrickson
320-221-2273
brianehendrickson nr gmail.com
,,,,,ti,.
.. , " CERTIFIED
;ti . PROFESSIONAL.
1